tbuckley/cabot-search huggingface dataset:
GETNE-SILVELUL study: A new immunohistochemical score (SPI) in patients (pts) with pancreatic neuroendocrine tumors (PanNET) treated with everolimus or captem.
Authors: Antonio Viudez, Guillermo Crespo, Maria Luisa Gómez-Dorronsoro, Marta Benavent, Jorge Hernando, Saioa Goñi, Beatriz García, Isabel Sevilla, Vicente Alonso, Iranzu González-Borja, Carlos Lopez, Ana Custodio, Irene Hernandez, Marta Llanos, Alberto Carmona, Jairo Pérez-Sanz, Borja López San Vicente, Ana De Jesus-Acosta
Journal: Journal of Clinical Oncology (2020)

e16707 Background: Previously our group showed the potential use of a score based (SPI) on MGMT, NDRG-1 and PHLDA-3 immunohistochemistry (IHC) expression as predictor of outcome in operated PanNET (Viúdez et al. Oncotarget 2016). The present retrospective multicenter project is analyzing the predictive/prognosis role of MGMT, NDRG-1 and PHLDA-3 in patients treated with advanced PanNET treated CAPTEM or everolimus. Methods: IHC nuclear staining for MGMT and PHLDA-3 is being scored as 0, 1-5%, 6-50% and ≥ 51%. For NDRG-1, we are using a cytoplasmic score from 0 to 2 based on distribution pattern (null, patched or diffuse). Results: 60 of 105 pts have been fully analyzed., most of then women (53%) and median age of 63 (27-79). 30 pts were treated with CAPTEM and 30 pts with everolimus. Median previous lines were 1 (21,7% received chemotherapy previously), and 91,7% pf pts had ki67 &lt; 20%. 65,5%, 10,2% and 29,1% were null for MGMT, NDRG-1 and PHLDA-3 IHC analysis. In the entire cohort K-M analysis showed significant differences for PFS or OS based on best response observed (p = 0,0001) and number previous lines received (p = 0,05), respectively. In pts treated with CAPTEM, log rank analysis showed significant differences for PFS (p = 0,047 HR:4,63 CI95%: 1,023-20,990) and OS (p = 0,040 HR:5,433 CI95%: 1,082-27,266) based on our SPI. Similar, although not significant, results were observed in everolimus-treated cohort for PFS (p = 0,529) and OS (p = 0,592) according to SPI. Conclusions: As it was described previously in operated PanNET, our SPI also seems to own predictive role in pts with advanced PanNET treated with CAPTEM or everolimus. More mature results of our work are needed and will be presented during 2020 ASCO Annual Meeting.
Examining the relationship between the clinical benefit of oncology drug indications and the time from pan-Canadian Oncology Drug Review (pCODR) recommendation to public reimbursement.
Authors: Sasha Thomson, Louis Everest, Noah Witzke, Seanthel Delos Santos, Matthew C. Cheung, Kelvin K. Chan
Journal: Journal of Clinical Oncology (2020)

e19360 Background: We examined if publicly reimbursed oncology drug indications with evidence of high clinical benefit, as measured by the American Society of Clinical Oncology Value Framework v2 (ASCO-VF), and European Society for Medical Oncology Magnitude of Clinical Benefit Scale v1.1 (ESMO-MCBS), received reimbursement status faster than those with lower clinical benefit from the time of pCODR recommendation. Methods: Oncology drug indications that received pCODR recommendations between Jan 2012 and July 2018 were identified. Indications that did not receive provincial reimbursement, without notice of compliance, or received a negative pCODR recommendation were excluded. The relationship between clinical benefit, as measured by ASCO-VF and ESMO-MCBS, and the time to reimbursement was evaluated using Spearman correlation coefficient, univariable, and multivariable linear regression analyses. Results: Overall, 84 indications met inclusion criteria yielding 80 ASCO-VF and 66 ESMO-MCBS scores. The mean ASCO-VF and ESMO-MCBS scores were 38.8 (SD = 23.8) and 3.0 (SD = 1.1) respectively. Higher ASCO-VF and ESMO-MCBS scores had low correlation with shorter time to provincial funding, (rho = -0.15, 95%CI -0.24, -0.06) and (rho = -0.25, 95%CI -0.34, -0.16) respectively. Univariable analyses showed that manufacturer reported incremental cost effectiveness ratio (ICER) values, year of pCODR recommendation, province and cancer type were associated with time to public reimbursement (all p &lt; 0.0001). After adjusting for potential confounders in the respective multivariable analysis, ASCO-VF (p = 0.29) and ESMO-MCBS (p = 0.15) scores were not significantly associated with time to public reimbursement. Year of pCODR recommendation remained associated with time to public reimbursement (p &lt; 0.001). Earlier years (2012-2014) had a shorter time to reimbursement (mean = 10.4 months) than later years (2015-2018) (mean = 14.5 months). Other factors that were associated with time to reimbursement in multivariable analysis were province (p &lt; 0.001) and cancer type (p &lt; 0.001). Conclusions: Currently, oncology drug indication with evidence of high clinical benefit do not appear to be funded faster than those with low clinical benefit. This suggests the need to prioritize cancer drug indications based on clinical benefit in order to allow for timely public reimbursement of cancer drugs with higher clinical benefit to patients.
首诊于眼科的糖尿病患者对糖尿病认知情况的调查
Authors: 敖丽君, 帕丽旦, 茹仙古丽
Journal: BMJ (2007)

我国糖尿病防治现状中知晓率低的现象令人担忧.要想遏制糖尿病上升的势头,不仅需要尽快解决群众知晓率低的问题,提高临床医生的早期诊断率也同样重要.1999年6月至2005年8月,在我院行眼底荧光血管造影检查的糖尿病患者1026例,在初诊的974例患者中,56例因视力降低或眼部疾病首诊于眼科门诊.本研究对首诊于眼科的糖尿病患者眼部疾病及其对糖尿病的认知水平进行测评分析。
Application of round hepatic and falciform ligaments in acute abdominal repair: a report of 22 cases
Authors: Wen-jun Wang, Yun Dong, Li Liu, Xin Kang, Lei Jiang
Journal: BMJ (2013)

Retrospective study was conducted to analyze the efficacies of using round hepatic and falciform ligaments in acute abdominal repair for 22 cases between December 2010 to March 2013. There was no occurrence of perioperative mortality. Twenty patients (90%) were followed up for 3 to 24 months. All cases recovered favorably and no complications of common bile duct stricture, bile leakage, postoperative hemorrhage or pancreatic fistula occurred. The anatomic and morphological advantages of pedicled ligamentum teres hepatic and falciform ligaments have made it a high-quality autologous biological repair material applicable for a variety of acute abdominal repairs.


Key words: 
Pedicled ligamentum teres hepatic and falciform ligament; Abdomen, acute
Questionnaire survey of depression prevalence and associated risk factors in elder patients with low-vision in Beijing suburb
Authors: Zheng-jiang Wei, Li Zhang, Rui-qi Cao, Qi-sheng You, Labbe Antoine
Journal: BMJ (2013)

To explore the prevalence and risk factors of depression in low-vision elder patients aged 60-85 years residing at Beizhuang Township, Miyun county. The activity of daily living scale (ADL) and geriatric depression scale (GDS) were used for diagnosis and grade the severity of depression. The prevalence rate of depression was higher in low-vision patients (36.2%) than in the control group (15.5%, P<0.05). The need for assistance in daily activities was higher in low-vision patients than in the control group (χ2=13.57, P<0.01). Patients with good economic conditions, being cared by relatives and living with their spouse had lower levels of ADL and GDS (all P<0.05).


Key words: 
Depression; Low vision
Gradients Do Grow on Trees: A Linear-Time <i>O</i>(<i>N</i>)-Dimensional Gradient for Statistical Phylogenetics
Authors: Xiang Ji, Zhenyu Zhang, Andrew Holbrook, Akihiko Nishimura, Guy Baele, Andrew Rambaut, Philippe Lemey, Marc A Suchard
Journal: Molecular Biology and Evolution (2020)

Abstract Calculation of the log-likelihood stands as the computational bottleneck for many statistical phylogenetic algorithms. Even worse is its gradient evaluation, often used to target regions of high probability. Order O(N)-dimensional gradient calculations based on the standard pruning algorithm require O(N2) operations, where N is the number of sampled molecular sequences. With the advent of high-throughput sequencing, recent phylogenetic studies have analyzed hundreds to thousands of sequences, with an apparent trend toward even larger data sets as a result of advancing technology. Such large-scale analyses challenge phylogenetic reconstruction by requiring inference on larger sets of process parameters to model the increasing data heterogeneity. To make these analyses tractable, we present a linear-time algorithm for O(N)-dimensional gradient evaluation and apply it to general continuous-time Markov processes of sequence substitution on a phylogenetic tree without a need to assume either stationarity or reversibility. We apply this approach to learn the branch-specific evolutionary rates of three pathogenic viruses: West Nile virus, Dengue virus, and Lassa virus. Our proposed algorithm significantly improves inference efficiency with a 126- to 234-fold increase in maximum-likelihood optimization and a 16- to 33-fold computational performance increase in a Bayesian framework.
Phase Ib study of a novel bivalent IAP antagonist APG-1387 in combination of pembrolizumab for patients with advanced solid tumors.
Authors: Drew W. Rasco, Nehal J. Lakhani, Yuefen Tang, Hengbang Wang, Jiao Ji, Jason Chen, ZHIYAN LIANG, Alex Amaya, Dajun Yang, Yifan Zhai
Journal: Journal of Clinical Oncology (2020)

3508 Background: APG-1387 is an IAP (inhibitor of apoptosis proteins) antagonist that has strong antitumor activity in multiple xenograft cancer models and acts as a host immune modulator, supporting its exploration for use in combination with checkpoint inhibitors for cancer therapy. Methods: This “3+3” dose escalation and dose expansion study evaluated APG-1387 combined with pembrolizumab in patients with refractory or intolerant advanced solid tumors (NCT03386526). APG-1387 was administered IV once weekly with pembrolizumab 200 mg on day 1 of a 21-day cycle. Study aims were to assess safety/tolerability, recommended phase 2 dose (RP2D), pharmacokinetics (PK), pharmacodynamics (PD), and efficacy. Results: As of December 25, 2019, total 28 patients had been treated in 3 dose cohorts of APG-1387: 20 mg (n = 4), 30 mg (n = 3), and 45 mg (n = 21, 18 in dose expansion). The median line of prior systemic cancer therapies was 3.0 (1-12). No dose-limiting toxicity was observed. The most common treatment-related adverse events (TRAEs; ≥10%) were fatigue (28.6%), arthralgia (14.3%), headache (14.3%), and tumor pain (10.7%). One patient in the 45-mg cohort had grade 2 Bell’s Palsy. G3 + TRAEs were autoimmune colitis, hypoxia, increased lipase, mucosal inflammation, pneumonitis, and tumor pain in 1 patient each (3.6%). Treatment-related SAEs were 1 G3 autoimmune colitis, 1 G2 myocarditis, and 1 G3 pneumonitis. The maximum tolerated dose (MTD)/RP2D for APG-1387 was 45 mg. Among 25 efficacy-evaluable patients, 1 with ER + , HER2 ‒ breast cancer receiving APG-1387 30 mg after failing 5 lines of therapy (PD-1 treatment-naïve, microsatellite stable) achieved confirmed PR (-79.2%) for 6 cycles but discontinued due to pneumonitis; another patient with PD-L1 ‒ non‒small-cell lung cancer treated at 45 mg had confirmed PR (-65.0%) for 6 cycles (ongoing). Other 11 patients had SD for 2-11 cycles. The disease control rate was 52%. Preliminary PK data showed a dose-proportional increase in APG-1387 exposure from 20 mg to 45 mg. Preliminary PD data showed that APG-1387 induced rapid degradation of cellular IAP1 and X-linked IAP in peripheral blood mononuclear cell samples; Increased serum release of interleukins (IL-12, IL-10) and monocyte chemotactic protein 4 was dose and time dependent. Conclusions: APG-1387 combined with pembrolizumab is well tolerated. Encouraging antitumor effects were observed in patients with several tumor types. The ongoing study will further evaluate the efficacy of this combination. Clinical trial information: NCT03386526 .
非那雄胺治疗良性前列腺增生症合并慢性前列腺炎的疗效观察
Authors: 敬思有, 包军胜
Journal: BMJ (2007)

对62例经临床确诊的良性前列腺增生症合并慢性前列腺炎的患者予口服非那雄胺5 mg/次、每日1次治疗,共6个月,分别于治疗前、治疗6个月后行国际前列腺症状评分、尿流率、残余尿量、前列腺体积及前列腺液常规等指标测定.治疗前后各项指标比较,差异有统计学意义(P＜0.05).说明非那雄胺治疗良性前列腺增生症合并慢性前列腺炎的疗效良好,尤其对前列腺增生体积较大者效果更好。
阻塞性睡眠呼吸暂停低通气综合征的发病机制
Authors: 陈宝元
Journal: BMJ (2005)

阻塞性睡眠呼吸暂停低通气综合征(OSAHS)占睡眠呼吸暂停低通气综合征(SAHS)人群的绝大部分,是SAHS发病机制和病理生理学研究的重点.OSAHS的发病机制既有局部的异常又有全身因素的参与,同时也有性别、年龄的影响。
Clinical features of esophageal foreign bodies difficult to remove by gastroscopy
Authors: Yu Zhao, Hesheng Luo, Ning Cui, Xiaojing Quan
Journal: BMJ (2018)

Objective
To analyze the clinical features of esophageal foreign body(EFB) difficult to remove by gastroscopy.


Methods
The clinical data of 159 patients with EFBs treated in Renmin Hospital of Wuhan University from January 2013 to April 2017 were analyzed retrospectively. Among 159 cases, the EFBs were removed by gastroscopy in 101 cases(gastroscope group)and removed by non-gastroscope method in 58 cases (non-gastroscope group), including 42 cases removed by esophagoscopy and 16 cases by surgery.The general information of patients, the types of EFB, the condition of impaction, treatments and outcomes of the two groups were analyzed.


Results
There was no significant difference in age and sex between gastroscope group and non-gastroscope group (P>0.05). The food typeEFBs included fish bone(n=77), chicken bone(n=45), jujube seeds (n=15), food bolus(n=4); and the non-food type FEBs included spectecleslens (n=2), bottle cap(n=11), denture(n=5). More than one half of FBs were located in the upper esophagus: 63.4%(64/101) in gastroscope group and 66.7%(28/42) in esophagoscope subgroup; however, EFBs were mostly located in the middle esophagus in surgery subgroup (62.5%, 10/16). In gastroscope group and esophagoscope subgroup, the sharp EFBs of length-diameter >2 cm were rare(n=4, 3.9% and n=3, 7.1%), but were common in the surgery group (n=9, 56.3%). The EFBs were successfully removed in all patients without massive hemorrhage or death. In gastroscope group(n=101), 93 cases had mucosal abrasion and bleeding, 5 cases had mild active bleeding, and 1 case had esophageal fistula. In surgical removal (n=16) there were 4 cases of esophageal perforation and postoperative inflammation, 3 cases of mediastinal inflammation and 2 cases of mediastinal abscess. Inesophagoscopic removal group (n=42), there were 2 cases of esophageal muscle layer abscess, 1 case of esophageal fistula and 1 case of pulmonary infection.


Conclusions
The most common type of EFBs is of food source.Foreign bodies in the upper and middle segments of the esophagusare difficult to remove with gastroscopy.In case of a sharp foreign body embedded in the middle esophagus, surgical removal is preferred to avoid severe sequences.


Key words: 
Esophageal; Foreign bodies; Gastroscope; Esophagoscopy; Surgical procedures, operative
Risk of Rare Cancers Among Solid Organ Transplant Recipients
Authors: Monica E D’Arcy, David Castenson, Charles F Lynch, Amy R Kahn, Lindsay M Morton, Meredith S Shiels, Ruth M Pfeiffer, Eric A Engels
Journal: JNCI Journal of the National Cancer Institute (2020)

Immunosuppressed solid organ transplant recipients (SOTRs) have elevated rates of certain rare cancers caused by viruses. Evaluating risk of rare cancers among SOTRs may provide etiological clues for additional cancers linked to poor immunity and viral infections.We performed a cohort study of 262 455 SOTRs (1987-2014) from the US SOTR registry linked to 17 population-based cancer registries. First cancers in SOTRs were categorized using an established classification scheme based on site and histology. Standardized incidence ratios (SIRs) compared risk in SOTRs with the general population. We used Poisson regression to calculate incidence rate ratios according to immune-related SOTR characteristics, including time since transplant (ie, duration of immunosuppression). All statistical tests were 2-sided.We examined 694 distinct cancer subtypes, with 33 manifesting statistically significantly elevated SIRs (Bonferroni P < 7.2 × 10-5). All 33 are rare (incidence <6 per 100 000 person-years) and several have known viral etiology (eg, Merkel cell carcinoma: SIR = 24.7, 95% confidence interval [CI] = 20.8 to 29.1). Additional cancers that were increased include squamous cell carcinomas of the lip (SIR range = 18.3-19.8), eye and adnexa (SIR = 13.8, 95% CI = 7.9 to 22.3), salivary gland (SIR = 9.3, 95% CI = 6.1 to 13.5), and nasal cavity and sinuses (SIR = 4.5, 95% CI = 2.8 to 6.8); sebaceous adenocarcinoma (SIR = 34.3, 95% CI = 26.3 to 44.0); malignant fibrous histiocytoma (15.4); and subtypes of bladder, kidney, lung, and colon cancer (SIR range = 3.2-13.3). Incidence of several cancers increased over time since transplant (Ptrend < .05), including squamous cell carcinomas of the lip, salivary gland, and anogenital sites.SOTRs experience elevated rates of several rare cancers. Because some of these cancers exhibit aggressive behavior with poor outcomes, it is important to further characterize the role of immunity and the potential involvement of oncogenic viruses to improve prevention and treatment.
Ten-year trends of mortality from cerebrovascular diseases in two resident areas in Henan
Authors: Shu-man Feng, Bing Wang
Journal: BMJ (2011)

The cluster sampling method was used and a retrospective survey on mortality trends of cerebrovascular diseases from 1989 to 2008 was conducted among residents from Erqi District in Zhengzhou city and Xigong District in Luoyang city. The average mortality rate of cerebrovascular diseases in these two districts was 69. 5/100 000 in 1989 to 2008. The standardized mortality rate for men was 118. 67/100 000 in 1989 to 1993, and dropped to 44. 23/100 000 in 2004 to 2008. The standardized mortality rate for women was 68.21/100 000 in 1989 to 1993, and dropped to 30. 2/100 000 in 2004 to 2008. The declining trends of cerebrovascular disease mortality rates might be related to early diagnosis and early treatment of the disease, and the extensive health education and prevention programs.

Key words: 
Cerebrovascular disorders;  Mortality
Two questions of reducing LDL-C by statins
Authors: Dayi Hu
Journal: BMJ (2016)

文章根据《中国成人血脂异常防治指南(2016年修订版)》评述了使用中小剂量他汀类药物治疗后LDL-C水平未达标怎么办以及如何理解LDL-C的控制目标两个问题，指出中国临床实践应遵从中国实际，遵从符合中国国情的中国指南。
Transthoracic echocardiography-guided percutaneous intervention for treatment of atrial septal defect complicated with pulmonary valvular stenosis in children
Authors: Xuning Lu, Ping Wen, Qilong Liu, Yuhang Liu, Wen Gao, Ye Zhao, Shengxi Yu, Quanwei Zhu
Journal: BMJ (2020)

Clinical data of 23 children with atrial septal defect and pulmonary valvular stenosis admitted in Dalian Children′s Hospital during March 2015 to March 2018 were retrospectively analyzed. Twenty patients were treated with percutaneous closure of atrial septal defect through femoral vein first, then transthoracic echocardiography-guided balloon pulmonary valvuloplasty was performed; while 3 patients had no balloon pulmonary valvuloplasty after percutaneous closure of atrial septal defect. Patients were followed up by transthoracic echocardiography and all were doing well. The transvalvular pressure fell under 35 mmHg (1 mmHg=0.133 kPa) [(19.5±1.9)mmHg] in all patients, which was significantly lower than that before treatment [(62.0±7.8 mmHg)] (t=28.92, P<0.01). During follow-up, no residual shunt of atrial septal defect was found; and mild pulmonary regurgitation occurred in 3 cases. The study indicates that combined percutaneous treatment with transthoracic echocardiography guidance is effective and safe for children with atrial septal defect and pulmonary valvular stenosis. The pulmonary artery stenosis of some patients can be alleviated, after closuring of the atrial septal defect.


Key words: 
Pulmonary valvular stenosis; Heart septal defect, atrial; Child; Transthoracic echocardiography
Influencing factors analysis of total satisfaction to community health service
Authors: Yan Ma, Kai-hong Chen
Journal: BMJ (2012)

Site surveys were conducted with a self-designed questionnaire for 4102 urban residents regarding their awareness and utilization rate of service projects and satisfaction (total satisfaction,medical environment,service attitude,content of communication and diagnostic & therapeutic modalities).The influencing factors of satisfaction were analyzed by multiple linear regression analysis.The factors of improving total satisfaction were as follows:①When content of communication,diagnostic & therapeutic modalities,service attitude and medical environment improved 10％,total satisfaction rose by 2.44％,2.50％,2.47％ and 0.98％ respectively; ② Utilization rate rose by 2.33％,1.60％ and 0.85％ respectively if they accepted home care services,rehabilitation services and chronic disease management services ; ③Total satisfaction rose by 0.94％ if they became aware of family planning and reproductive health services.And the factors of reducing total satisfaction were as follows:①total satisfaction declined by 1.68％ if their children accepted preventive vaccination services.②total satisfaction declined by 1.13％ if the respondents maintained their health records.

Key words: 
Community health services; Patient satisfaction
Patient-reported benefit from proposed interventions to reduce financial hardship during cancer treatment.
Authors: Emeline Aviki, Fumiko Chino, Julia Ramirez, Victoria Susana Blinder, Jennifer Jean Mueller, Mario M. Leitao, Nadeem Abu-Rustum, Francesca Gany
Journal: Journal of Clinical Oncology (2020)

7080 Background: Awareness of cancer patients’ financial toxicity (FT) has increased substantially over the past decade; however, interventions to minimize financial burden remain underdeveloped and understudied. This survey-based study explores patient beliefs on which potential mitigating strategies could improve their financial hardship during cancer treatment. Methods: Interviewer-administered surveys were conducted with consecutive patients in an outpatient, urban, private academic Gynecologic Cancer clinic waiting room for 2 weeks in August 2019. The survey items included patient demographics, disease characteristics, the Comprehensive Score for Financial Toxicity (COST) tool (validated measure of FT with score 0-44; lower scores indicate worse FT), assessment of cost-coping strategies, and patient-reported anticipated benefit from described potential interventions (items that were feasible and relevant to implement in clinic). Results: Of 101 patients who initiated the survey, 87 (86%) completed it and were included in this analysis. The median age was 66 (range, 32-87). Thirty-eight patients (44%) had ovarian, 29 (33%) uterine, 5 (6%) cervical, and 15 (17%) an “other” gynecologic cancer. The median COST score was 32 (range, 6-44). Twenty-nine patients (33%) had COST scores ≤25 and 16 (18%) had COST scores ≤18. The most frequent cost-coping strategy reported was reducing leisure activities (n = 36, 41%) and using savings to pay for medical bills (n = 34, 39%). Six patients (7%) reported not taking a prescribed medication in the past 12 months due to the inability to pay and 0 reported skipping a recommended imaging study. When it came to interventions patients anticipated would improve their current financial hardships, 34 (39%) indicated access to transportation assistance to and from appointments, 31 (36%) said “knowing up front how much I’m going to have to pay for my healthcare”, 29 (33%) indicated “minimizing wait time associated with appointments, which keeps me away from work”, and 22 (25%) indicated “access to free food during/around appointments and treatments”. Only 26 (30%) noted they were not experiencing financial hardship. Conclusions: For an outpatient population of gynecologic cancer patients, several focused, feasible interventions could be implemented to potentially decrease patient FT. Our study can help health care providers in the design of interventions to create meaningful improvements in patient financial burden. Next steps should assess the impact of targeted interventions on patient outcomes.