tbuckley/cabot-search huggingface dataset:
Abstract MP18: Vicarious Experience Trumps Neighborhood Characteristics in Predicting Leisure-time Physical Activity in the Multi-ethnic Study of Atherosclerosis Dataset
Authors: Jacob K Kariuki, Bonny Rockette-Wagner, Jessica Cheng, Lora E Burke, Kirk Erickson, Dara Mendez, Susan M Sereika, Bethany Barone Gibbs
Journal: Circulation (2020)

Background: Social cognitive theory (SCT) postulates that observing similar others succeed (vicarious experience) can improve self-efficacy and motivate action. The utility of vicarious experience has been demonstrated in controlled laboratory and clinical settings, but its operationalization and applicability for promoting physical activity (PA) in community settings remains unknown. Characterizing vicarious experiences and other neighborhood factors that are associated with improved PA in the community could help enhance exercise self-efficacy and PA. This secondary analysis examines neighborhood factors that predict leisure-time PA during exam 5 of the Multi-Ethnic Study of Atherosclerosis (MESA). Methods: The sample included MESA subjects who participated in exam 5 (N= 4,716). Leisure-time PA was assessed using the MESA Typical Week PA Survey. Neighborhood behaviors and characteristics, including vicarious experiences (operationalized as observing others “exercise” or “walk”), perceived safety, crime, and walkability, were self-reported. Group comparative analyses were used to evaluate differences in categorical and continuous variables. The relationships between neighborhood characteristics and optimal leisure-time PA (≥10 MET-hrs/wk) were assessed using logistic regression adjusting for age, gender, race, income, body mass index (BMI), and depression, and including interactions between race, BMI and age. Adjusted odds ratios with 95% confidence intervals (CI) are reported. Results: Participants with complete data on variables of interest (n=4,417) were elderly (age 69.8 ± 9.4 yrs), predominantly female (53%), and diverse (40% white, 12% Chinese, 26% black, 22% Hispanic). Participants who saw people exercise in their neighborhood were 44% (OR 1.44, 95% CI; 1.22 - 1.69) more likely to engage in optimal leisure-time PA compared to those who did not. Observing other people walk in the neighborhood did not impact leisure-time PA (OR 0.84, 95% CI; 0.68 - 1.04). Older age, female gender, obesity, minority status, and high-risk for depression were associated with lower odds of engaging in optimal leisure-time PA controlling for vicarious experience. Race had significant interactions with BMI and age. Other neighborhood characteristics including perceived safety, crime, and walkability did not influence the association between seeing similar others engage in PA and their own engagement in PA. Conclusions: Developing PA programs that expose community-dwelling adults to their peers who engage in PA could improve exercise self-efficacy and adherence to PA guidelines.
Abstract 10023: Free Fatty Acids and Myocardial Infarction, Coronary Heart Disease, Cardiovascular Disease
Authors: Sarah O Nomura, Amy B Karger, Natalie L Weir, Michael Y Tsai
Journal: Circulation (2019)

Introduction: Free fatty acids (FFA) are an important energy substrate during fasted conditions, but elevated FFAs may be associated with cardiovascular disease (CVD) and mortality. However, most p...
Abstract P376: Associations Between Moderate To Vigorous Physical Activity And Sedentary Time On Cognitive Function In Older Adults With Cardiovascular Disease
Authors: Nicole M Hoffmann, Megan E Petrov
Journal: Circulation (2020)

Cardiovascular disease (CVD) is associated with increased risk for cognitive decline. Lifestyle behaviors such as moderate to vigorous physical activity (MVPA) and reduced sedentary time (ST) may mitigate this decline, but limited research exists. The aim of the study was to examine the joint association of MVPA and ST on cognitive function by CVD status. Adults (n=2844, ≥60yrs) from the 2011-2014 National Health and Nutrition Examination Survey underwent cognitive testing (Digit Symbol Substitution Test [DSST]; Animal Fluency [AF]). Participants reported minutes of MVPA per week (categorized by U.S. PA Guidelines: ≥ 150min MPA and/or ≥ 75min VPA PA vs &lt;150min MPA and &lt;75min VPA), and typical ST per day (≤7hrs vs &gt;7hrs ) , and reported physician-diagnosed CVD (i.e., myocardial infarction, stroke, coronary heart disease, or heart failure). Weighted linear regression analyses assessed the joint association of MVPA and ST on cognitive function, and tested the modifying effect of CVD status (alpha level for interaction terms set at 0.1) after adjustment for demographics, hypertension, diabetes, body mass index, and depression symptomatology. See Table. There were significant main effects for combined MVPA-ST groups on DSST (Wald F (3,30)=4.92, p =.007) and AF (Wald F (3,30)=5.01, p =.006). Individuals who did not engage in MVPA regardless of ST had significantly worse scores on DSST compared to the reference group. There was a significant main effect for CVD on DSST (Wald F (1,32)=8.82, p =.006). There was a significant interaction between MVPA-ST groups and CVD status on DSST (Wald F (3,30)=3.691, p =.023). Stratified analyses indicated among individuals with CVD, the buffering effect of MVPA was maintained, but the interaction was not significant for those without CVD. In a sample of adults with a history of CVD, meeting recommendations for MVPA appeared to preserve executive functioning regardless of ST. This research highlights the added importance for people with a history of CVD to participate in the recommended amount of MVPA.
Bevacizumab and irinotecan in patients (pts) with recurrent glioblastoma multiforme (GBM)
Authors: S. Raval, S. Hwang, L. Dorsett
Journal: Journal of Clinical Oncology (2007)

2078 Background: Primary GBM exhibits overexpression or amplification of the epidermal growth factor gene. The effectiveness of bevacizumab and irinotecan in pts with relapsed GBM was first reported in 2005 (Stark-Vance, et al, Neuro-Oncol, 2005). In this report, we assess the effects of combination of bevacizumab and irinotecan on overall responses, toxicity, cognitive function and functional status in recurrent GBM pts. Methods: From August 2005 to December 2006, 22 consecutive GBM pts failed &gt; 1 prior chemotherapy with measurable disease on MRI were included. Each patient received bevacizumab 5mg/kg IV and irinotecan 125mg/m2 IV infusion every 2 weeks until disease progression or developed unacceptable toxicity. The response was determined by MRI every 2 cycles. Cognitive function was assessed by Blessed Orientation-Memory-Concentration Test (BOMC) and functional status was assessed by Karnofsky performance status (KPS), Barthel Index (BI) and Instrumental Activities of Daily Living (IADL) prior to each cycle of treatment. Descriptive statistics analysis was used. Results: All pts failed temozolomide and radiation therapy; 1 pt had prior BCNU and 2 pts had prior irinotecan treatment. The median (M) age was 55 years (37-77) with pre treatment M KPS 80 (40–80), BOMC 7 (0–28), BI 85 (10–100) and IADL 6 (0–17); 12 pts exhibited mild (3 pts), moderate (7 pts) to severe (2 pts) cognitive impairment. The M number of cycles received was 8 (2–27); 21 pts are evaluable for MRI responses with 95.2% response rate (2CR’s + 14PR’s + 4 minimal responses). Seven pts have expired; the M length of survival was 4.6 months (range 1.1–15.4+) and the M time to progression was 3 months (0.5–13.8+). There were only two grade 3 thrombocytopenia and one grade 3 neutropenia. Improvement in BOMC score was seen in 15 pts (62%) with M improvement of 7 point. Improvement in functional status was seen in 18 pts (85.7%) with M improvement in KPS by 10 point, BI by 8 points and IADL by 2 point. Conclusions: The combination of bevacizumab and irinotecan is well tolerated and safe. The overall response rate was 95.2% and significant improvements in cognitive functional and functional status were demonstrated. The longer follow up will determine the impact of this most active combination. No significant financial relationships to disclose.
Abstract P454: Impact of Air Pollution on Subclinical Atherosclerosis Risk in Middle Aged Women With and Without Polycystic Ovary Syndrome
Authors: Lei Zhu, Evelyn O Talbott, Ada O. Youk
Journal: Circulation (2020)

Objective: To study the association of ambient air pollution and subclinical atherosclerosis (SCA) risk in middle aged women with and without a history polycystic ovary syndrome (PCOS). Background: The harmful impact of air pollution relates to the increased risk in cardiovascular disease (CVD), a leading cause of mortality in the US. Atherosclerosis measured by coronary artery calcification (CAC) is highly correlated with the degree of atherosclerosis. Fine particulate matter (particles ≤ 2.5 μm in aerodynamic diameter [PM 2.5 ]), is known to affect cardiovascular health, but no study has focused on the impact in middle aged women with PCOS, a heterogeneous disorder involving altered ovarian function and often with higher risk of CVD. Methods: We evaluated 310 women (at first visit: age 47.7 ± 6.3 years; BMI 30.1 ± 7.6; 46.4% PCOS) from the Cardiovascular Health and Risk Measurement III study, who had data on SCA measured by CAC Agaston score, PCOS measures and PM 2.5 levels. Logistic regression models were used to estimate the association between PM 2.5 exposures (categorized into quartiles) and CAC (categorized into a binary variable, where CAC Agaston score ≤ 10 as reference group), adjusting for age, BMI, and PCOS status. Subgroup analyses were conducted to test associations between PM 2.5 and CAC among the vulnerable population of women with PCOS. Results: Annual mean PM 2.5 levels were 16.8 ± 1.1 and 16.6 ± 1.3 μg/m 3 , respectively, among women with CAC Agaston score &gt; 10 and ≤ 10 (N=76 vs. 234). In addition, women with PCOS had an annual mean PM 2.5 levels of 16.5 ± 1.3 μg/m 3 , and women without PCOS had an annual mean PM 2.5 levels of 16.8 ± 1.1 μg/m 3 (N=143 for PCOS cases vs. 165 for controls). In adjusted analysis, the odds ratio of CAC risk was 1.32 (95% CI: 0.54, 3.28) for the highest quartile of PM 2.5 vs. the lowest one (Q4: 17.5-18.9 VS. Q1: 12.7-16.0 μg/m 3 ). Within the PCOS group, the likelihood of CAC was 4.78 times higher (95% CI: 1.37, 16.76) in the highest quartile of PM 2.5 levels, compared to the lowest. Conclusions: Women with PCOS appear to be at higher risk for the impact of PM2.5 exposure on SCA, compared to those without PCOS in this middle aged group. Replication of this work in other groups of women with PCOS would be of a high priority.
Abstract 19267: Can a "Physician-Less" System of Automated Prehospital STEMI Diagnosis and Catheterization Laboratory Activation Reduce the Treatment Delay Gap Between Men and Women?
Authors: Christine Pacheco, Alexis Matteau, Alexandra Bastiany, François Gobeil, Simion Oana, Andre Kokis, Samer Mansour, Brian J Potter
Journal: Circulation (2017)

Introduction: Women with STEMI have been shown to experience longer treatment delays (TD) than men, some of which may be due to physician bias. Recently, automated “physician-less” prehospital STEM...
<sup>18</sup>F-FDG PET changes management and improves prognostic stratification in patients with colorectal cancer: results of a prospective, multi-centre study
Authors: A. M. Scott, D. Gunawardana, B. Kelly, J. Stuckey, A. Byrne, J. Ranshaw, M. Fulham
Journal: Journal of Clinical Oncology (2007)

4025 Background: The aims were to: 1) examine the impact of PET in changing management in patients with proven or suspected recurrence of colorectal cancer and, 2) assess the impact of management change on disease free survival. Methods: Symptomatic patients (Group A) with a residual structural lesion suspicious for recurrent tumour, or patients (Group B) with pulmonary or hepatic metastases, which were potentially resectable as determined by conventional imaging, underwent PET scans. Pre- and post-PET management plans were documented blinded to PET results. Patients were followed for 12 months to determine actual management and to assess clinical outcomes. Results: A total of 191 patients (118M:73F, mean age 66 yrs) were recruited. PET detected additional sites of disease in 48.4% of Group A and 43.9% of Group B patients. Importantly, a change in planned management was documented in 65.6% of Group A and 49.0% of Group B patients. Follow-up confirmed implementation of management plans in 96% of patients. Analysis of follow-up data to 12 months post- PET showed that in Group A progressive disease was identified in 60.5% of patients with additional lesions detected on PET compared with conventional imaging, and 36.2% patients with no additional lesions detected by PET (p=0.0364); in Group B progressive disease was identified in 65.9% of patients with additional lesions detected on PET and 39.2% patients with no additional lesions detected by PET (p=0.0198). Patient follow-up also showed that PET provided valuable prognostic information in patients stratified into curative/palliative intent groups. Conclusions: These data unequivocally demonstrate the significant impact of PET on management and outcomes in patients with suspected recurrent colorectal cancer. No significant financial relationships to disclose.
Exploration of pain management following implementation of WHO pain guidelines
Authors: S. Subongkot, S. Khounnikhom, N. Pratheepawanit Johns, A. Sookprasert
Journal: Journal of Clinical Oncology (2007)

19646 Background: Pain is among the most common symptoms encountered in cancer patients and remains the first priority of care. Methods: This cross sectional study aimed to explore a pattern of pain management at KKU Hospital by utilizing a numeric rating scale (0–10). Cancer pain patients were categorized based on prior analgesic exposure into two groups; Naïve group, and Routine group. Treatments were defined according to WHO as 1) drug treatment relevant to pain severity, 2) analgesics being prescribed as around-the- clock and 3) analgesics used for break-through pain for patients receiving strong opioid. Results: From Dec 2005 to Jul 2006, 261 patients were enrolled. 93.1% (n=243) were in advanced stages and 88.5% (n=231) were in moderate to severe pain. This pain interfered with patient’s daily life activities mildly to moderately as each pain score increased (p-value&lt;0.01). In Naive group (n=159), 32.7% (n=52) were given analgesics following the WHO on both days 1 and day 3 of admission whereas 40.2% (n=64) patients were not. A decreased pain score was greater (2.61, SD±1.5) in a group following the WHO on day 1. Additionally, a decreased pain score was greater (3.91, SD±1.8) in a group following the WHO on day 3 (p-value &lt;0.0001). This pain score decreased was also clinically significant as pain score reduced more than 3 points. In Routine group (n=102), 32 (31.4%) were given analgesics following the WHO guideline on both day 1 and day 3 of admission. In contrast, 36 (35.3%) were not. A decreased pain score was greater (2.59, SD±1.8) in a routine group following the WHO on day 1. Moreover, a decreased pain score was greater (3.95, SD±1.8) in a group following the WHO on day 3. The clinical significance of pain score reduced was also found on day 3. Of the 261 evaluable patients, the pattern of analgesics usage following the WHO guideline was increased in both groups comparing to at the beginning of the study. Conclusions: The results demonstrated that patients who received pain management following the WHO guideline reported significantly lower pain intensity than those not following the WHO. No significant financial relationships to disclose.
Abstract P4-01-17: Viable circulating ensembles of tumor associated cells persist in patients with no radiologically detectable disease after treatment in breast cancer
Authors: Ajay Srinivasan, Dadasaheb Akolkar, Darshana Patil, Timothy Crook, Cynthe Sims, Revati Patil, Vineet Datta, Anantbhushan Ranade, Pradip Fulmali, Pradip Devhare, Pooja Fulmali, Shoeb Patel, Akshay Ainwale, Sneha Puranik, Rajan Datar
Journal: Cancer Research (2020)

Abstract Oncological orthodoxy holds that (metastatic) breast cancer is an incurable disease. Response evaluation in metastatic breast cancer is determined by clinical, biochemical and radiological parameters, FDG PET CT being the imaging modality of choice for most types of breast cancer. However, even in cases where FDG PET CT and/or normalisation of serum tumour markers imply complete response to systemic therapy, durable disease-free survival is uncommon. To explore the mechanistic basis underlying persistent disease in spite of apparently effective systemic therapy, we hypothesized that Circulating Metastatic Disease (CMD) in the form of viable tumor cells or clusters might be a feature of persisting breast cancer. To address this, we obtained 15ml of peripheral blood from 927 known and previously treated cases of breast cancers immediately prior to FDG PET CT restaging. Peripheral blood mononuclear cells (PBMCs) were harvested by centrifugation. Circulating Ensembles of Tumor Associated Cells (C-ETACs), which are clusters of heterotypic apoptosis resistant cells of tumorigenic origin were enriched by a novel process using a combination of commercially available stabilizing agents. C-ETACs were characterized by immunostaining for EpCAM, pan-CK and CD45 as well as GCDFP-15 or GATA3. 927 patients underwent FDG PET CT of whom 731 (78.9%) had evidence of FDG avid residual disease. 196 patients (21.1%) had no metabolically active disease, among whom C-ETACs were detected in 171/196 cases (87.2%). The presence of CMD in a high proportion of cases in patients with no evidence of metabolically active disease implies that the majority of patients in whom conventional parameters of disease are negative have residual disease and are not biologically cured. Citation Format: Ajay Srinivasan, Dadasaheb Akolkar, Darshana Patil, Timothy Crook, Cynthe Sims, Revati Patil, Vineet Datta, Anantbhushan Ranade, Pradip Fulmali, Pradip Devhare, Pooja Fulmali, Shoeb Patel, Akshay Ainwale, Sneha Puranik, Rajan Datar. Viable circulating ensembles of tumor associated cells persist in patients with no radiologically detectable disease after treatment in breast cancer [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-01-17.
Secondary care provider attitudes towards patient generated health data from smartwatches
Authors: Jordan M. Alpert, Todd Manini, Megan Roberts, Naga S. Prabhakar Kota, Tonatiuh V. Mendoza, Laurence M. Solberg, Parisa Rashidi
Journal: npj Digital Medicine (2020)

Abstract Wearable devices, like smartwatches, are increasingly used for tracking physical activity, community mobility, and monitoring symptoms. Data generated from smartwatches (PGHD_SW) is a form of patient-generated health data, which can benefit providers by supplying frequent temporal information about patients. The goal of this study was to understand providers’ perceptions towards PGHD_SW adoption and its integration with electronic medical records. In-depth, semi-structured qualitative interviews were conducted with 12 providers from internal medicine, family medicine, geriatric medicine, nursing, surgery, rehabilitation, and anesthesiology. Diffusion of Innovations was used as a framework to develop questions and guide data analysis. The constant comparative method was utilized to formulate salient themes from the interviews. Four main themes emerged: (1) PGHD_SW is perceived as a relative advantage; (2) data are viewed as compatible with current practices; (3) barriers to overcome to effectively use PGHD_SW; (4) assessments from viewing sample data. Overall, PGHD_SW was valued because it enabled access to information about patients that were traditionally unattainable. It also can initiate discussions between patients and providers. Providers consider PGHD_SW important, but data preferences varied by specialty. The successful adoption of PGHD_SW will depend on tailoring data, frequencies of reports, and visualization preferences to correspond with the demands of providers.
Taxane based neoadjuvant chemotherapy in locally advanced esophageal cancer: A single centre experience
Authors: I. B. Ambulkar
Journal: Journal of Clinical Oncology (2007)

15143 Background: Neoadjuvant taxane based chemotherapy may improve response rate in patients with locally advanced esophageal cancer. We have evaluated paclitaxel based induction chemotherapy in patients with locally advanced esophageal cancer to determine its feasibility, clinical response, radiological and endoscopic response. Methods: etween November 2004 to October 2006, 30 patients were enrolled in this study. All patients were categorized as locally advanced esophageal cancer. They underwent CT scan chest and upper GI endoscopy before chemotherapy and 3 cycles after the chemotherapy. Chemotherapy included 3 cycles of paclitaxel (135 mg/m2 on day 1),5FU (500 mg/m2 on day 1,2,3) and cisplatin (25 mg/m2 on day 1,2,3) every 21 days. The main endpoint was response evaluation. Twenty one (70%) had squamous cell carcinoma and 9(30%) had adenocarcinoma. Median age was 44 years (39–75), 22(73.3%) were males and 8 were(26.6%) females. Dysphagia was the predominant symptom in 28 (93.3%) patients. Results: All 30 patients were evaluable for response and toxicity. Radiological and endoscopic CR was seen in 6(20%), PR in 16(53.3%),5(16.6%) had SD and 3(10%) had PD. Twenty five (83.3%) patients underwent radiotherapy to a total dose of 4500 cGY,5(16.6%) underwent surgery, 2(6.6%) showed complete pathological response. Observed toxicity was predominantly hematologic and leucopenia grade III/IV in 10% of cycles, Hb grade III/IV in 6.6% and thrombocytopenia grade III/IV in 3% of cycles.6.6% patients developed grade III/IV oral mucositis. Conclusions: Addition of paclitaxel to cisplatin and 5FU as neoadjuvant chemotherapy in esophageal cancer appears to be highly effective with complete as well as partial response rates. It can be given safely with manageable side effects. It is predicted that combination of paclitaxel, cisplatin and 5FU having excellent response as neoadjuvant therapy will also produce long term benefits. No significant financial relationships to disclose.
Effect of an intensive lifestyle intervention on the prevalence of metabolic syndrome and its components among overweight and obese adults
Authors: Macklin E. Guzman, Edward A. Zbella, Sejal Shah Alvarez, Jennifer Lynn Nguyen, Eva Imperial, Frank J. Troncale, Christina K. Holub, Ashpreet Kaur Mallhi, Sara VanWyk
Journal: Metabolism (2020)