tbuckley/cabot-search huggingface dataset:
Influencing factors of exercise tolerance in patients with coronary heart disease
Authors: Lan Wang, Danjie Guo, Xuhang Huang, Jingmin Hu, Qianqian Niu-Ya, Yadan Zou, Wenying Cao, Lin Guo
Journal: BMJ (2016)

Objective
To investigate the influencing factors of exercise tolerance in patients with coronary heart disease.


Methods
A total of 136 patients who were diagnosed as coronary heart disease (CHD) by coronary angiography and underwent cardiopulmonary exercise testing (CPET) were enrolled. Exercise capacity was evaluated by peak oxygen consumption(VO2peak)value in CPET, patients were divided into exercise capacity normal group (n=45) and abnormal group (n=91) according to VO2peak% value. Clinical manifestations, combined diseases, medications, CHD situations and ultracardiographic findings of patients were documented and the influencing factors were examined with multivariate logistic regression analysis.


Results
The rate of patients aged≥65 years in exercise capacity abnormal group was lower than that in normal group; the rates of smoking history, diabetes mellitus, heart failure, myocardial infarction, percutaneous coronary intervention(PCI)in exercise capacity abnormal group were higher than those in normal group[13.2%(12/91)vs. 33.3%(15/45), 49.4%(45/91)vs. 31.1%(14/45), 42.9%(39/91)vs. 20.0%(9/45), 25.3%(23/91)vs. 6.7%(3/45), 64.8%(59/91)vs. 33.3%(15/45), 81.3%(74/91)vs. 64.4%(29/45), respectively ; all P<0.05]. The VO2peak in exercise capacity normal group and abnormal group were (26±4) and (20±3)ml/(kg·min), respectively(t=7.914, P<0.01). The VO2peak in patients with myocardial infarction[(21±4)ml/(kg·min)]was lower than that without myocardial infarction[(23±4)ml/(kg·min)](t=2.093, P=0.038). The VO2peak in diabetes mellitus patients[(20±4)ml/(kg·min)]was lower than that without diabetes[(23±4)ml/(kg·min)](t=3.573, P<0.01). The VO2peak between smokers and non-smokers was not significantly different (t=1.494, P=0.138), but the VO2peak % in smokers was significant lower than that in non-smokers[(73±14)% vs.(82±19)%, t=2.983, P=0.003). Multivariate logistic regression analysis showed that history of diabetes mellitus and history of myocardial infarction were the independent risk factors for the declined exercise capacity in CHD patients (OR=4.04, 95%CI: 1.283-12.721, P=0.017; OR=6.80, 95%CI: 2.416-19.121, P<0.01).


Conclusions
The VO2peak in patients with diabetes or myocardial infarction are lower than that without diabetes or myocardial infarction. Diabetes and myocardial infarction are independent risk factors of declined exercise capacity in CHD patients.


Key words: 
Coronary artery disease; Exercise test; Exercise tolerance; Risk factors
Neoadjuvant cisplatin based therapy in bladder cancer: Is less enough?
Authors: Saqib Abbasi, Mohammed Al-Jumayli, Hannah Hildebrand, Elizabeth Marie Wulff-Burchfield, Eugene K. Lee, John A Taylor, Jeffrey Holzbeierlein, Grace Martin, Rahul Atul Parikh
Journal: Journal of Clinical Oncology (2020)

e17046 Background: Patients receiving neoadjuvant chemotherapy (NAC) for muscle invasive bladder cancer (MIBC) often are not able to complete three or four cycles of therapy which is standard of care. Pathological completed response (pCR) is a surrogate marker for long term survival. We set out to determine if pCR differed based on total tolerated cycles prior to surgery in those receiving cisplatin based NAC. Methods: Data was gathered at our institution on patients receiving neoadjuvant gemcitabine with cisplatin (GC), or dose dense methotrexate, vinblastin, adriamycin, cisplatin (ddMVAC)). The primary outcome was pCR, and secondary outcome was downstaging. pCR was compared between those who received 1-2, 3, and 4 cycles. Results: A total of 92 patients receiving NAC during the years of 2014 to 2019. 12 received 2 or less cycles, 22 received 3, and 57 completed 4. Age was not significantly different between groups (69.7, ≤ 2), (69.0, 3), (67.4, 4). Gender differences were noted: (41.7% female, ≤ 2), (22.7% female, 3), (12.3% female, 4), p = 0.05. The rates of pCr among the three groups were: (16.7%, ≤ 2), (22.7%, 3), (40.4%, 4), p = 0.14. Downstaging was seen in: (33.3%, ≤ 2), (59.1%, 3), (52.6%, 4), p = 0.35. Conclusions: While not statistically significant our study suggests a trend on pCR rates related to the total of cycles of neoadjuvant chemotherapy prior to surgery. Limitations include retrospective design and small sample size.
Survey on knowledge of home blood pressure monitoring in community physicians of Zhejiang province
Authors: Xinran Huang, Xiaoling Xu, Xinhua Tang, Tianwu Jing, Hongjian Ding
Journal: BMJ (2014)

Objective
To survey on knowledge of home blood pressure monitoring (HBPM) in community physicians of Zhejiang province.


Methods
One hundred and thirty eight community physicians from Xiacheng District of Hangzhou Municipality were assigned in intervention group (n=70) or control group (n=68). The knowledge of home blood pressure monitoring was surveyed by using the China HBPM questionnaire in both groups.


Results
Total 132 valid questionnaires were returned, including 70 from intervention group and 62 from control group. The results showed that 80.0% (61/70) physicians in intervention group and 62.9% in control group frequently suggested hypertensive patients to have HBPM in out-patient clinics (P<0.05). Physicians who correctly instructed patients to use upper arm electronic sphygmomanometer, to measure blood pressure in morning and night, to repeat 2-3 times each time, to record result 3 times, and to take ≥135/85 mmHg(1 mmHg=0.133 kPa) as criteria of hypertension in intervention and control groups were 67.1% (47/70) versus 32.3% (20/62), 5.7% (39/70) versus 29.0% (18/62), 92.9% (65/70) versus 66.7% (40/62), 38.6% (27/70) versus 6.4% (4/62) and 57.1% (40/70) versus 38.7% (24/62), respectively, and the differences between two groups were all statistically significant (P<0.05). As for measuring frequency, 92.9% (65/70) physicians in intervention group and 67.7% (42/62) in control group considered that blood pressure should be measured every day for poorly controlled patients; 81.4% (61/70) versus 14.5% (9/62) considered that blood pressure should be measured every week for well-controlled patients; 87.1% versus 35.5% (22/62) considered that blood pressure should be measured every year at least for people with normal blood pressure; there were significantly differences between two groups (P<0.05). The community physicians generally considered that HBPM can be used to improve the awareness of hypertension for patients and to increase the blood pressure control rate in community.


Key words: 
Plood pressure determination; Questionnaires; Community health services
Application of objective structured clinical examination (OSCE) for completion of general practice residency training
Authors: Qian Chen, Xiangjie Zhang, Miao Xu, Zhigang Pan
Journal: BMJ (2018)

Objective
To analysis the implementation of the objective structured clinical examination (OSCE) for completion of general practice residency training in Xinjiang Uygur autonomous region.


Methods
Ninety eight general practice residents took training-completion examination applying OSCE in Xinjiang Uygur Autonomous Region. The examiners (including SP examiners) and examinees were interviewed with questionnaire after the OSCE.


Results
All 60 examiners and 98 examinees were generally in favor of using OSCE in general practice residency training completion examination; 100.0% (60/60) examiners and 86.7% (85/98) examinees thought that it was necessary; 98.3% (59/60) examiners and 89.8% (88/98) examinees thought that the OSCE was able to evaluate the clinical competence of general practice; 95.0% (57/60) examiners and 78.6% (77/98) examinees thought the OSCE examination stations reasonable; 40.8% (40/98) examinees thought that the difficulty degree of the exam was moderate, 35.7% (35/98) and 20.4% (20/98) examinees thought that it was difficult or very difficult, particularly for history writing and case analysis.


Conclusions
The examiners and examinees recognize the advantages of OSCE in assessment of clinical competence. This study provides useful information for application of OSCE in general practice residency training completion assessment.


Key words: 
Objective structured clinical examination; General practitioner; Standardized training of residents
Biomarker data from KATHERINE: A phase III study of adjuvant trastuzumab emtansine (T-DM1) versus trastuzumab (H) in patients with residual invasive disease after neoadjuvant therapy for HER2-positive breast cancer.
Authors: Carsten Denkert, Chiara Lambertini, Peter A. Fasching, Katherine L. Pogue-Geile, Max S. Mano, Michael Untch, Norman Wolmark, Chiung-Sheng Huang, Sibylle Loibl, Eleftherios P. Mamounas, Gunter Von Minckwitz, Charles E. Geyer, Thomas Boulet, Chunyan Song, Gail Lewis Phillips, Malgorzata Nowicka, Sanne de Haas, Mark Basik
Journal: Journal of Clinical Oncology (2020)

502 Background: The phase 3 KATHERINE study (NCT01772472) compared adjuvant T-DM1 versus H in patients with residual invasive breast cancer after neoadjuvant chemotherapy plus HER2-targeted therapy. Here we report exploratory analyses of the relationship between invasive disease-free survival (IDFS) and biomarkers potentially related to response. Methods: Formalin fixed paraffin-embedded tissue samples were collected before neoadjuvant treatment and/or at surgery. Surgical samples were used for analyses, except when only pre-treatment samples were available (~20% of cases). DNA was derived to identify PIK3CA hotspot mutations and gene expression (RNA) analysis was used to detect HER2, PD-L1, CD8 and predefined immune signatures including 3-gene, 5-gene, Teffector, chemokine signaling, and checkpoint inhibitor signatures. RNA analysis was adjusted for tumor content and expression levels were dichotomized at the median into low (≤) and high (&gt;) groups. The effect of treatment and biomarkers on IDFS was assessed. Results: PIK3CA mutation (mut) status was available from 1363 (91.7%) patients. T-DM1 IDFS benefit was independent of PIK3CA mut status (mut: HR 0.54; 95%CI 0.23–0.90; non-mut: HR 0.48; 95%CI 0.35–0.65) and no impact of PIK3CA mut was observed within either treatment arm. Gene expression data were available from 1059 (71.3%) patients. Similar gene expression levels were observed between treatment arms, but, unlike the surgical samples (n = 815), the pre-treatment samples (n = 244) were not representative of the ITT population. Thus, subsequent analyses were based on surgical samples (H n = 398; T-DM1 n = 417). Consistent treatment benefit with T-DM1 vs H was observed across the single-gene and immune gene-signature subgroups as in the ITT population. High vs low HER2 expression was associated with worse outcome (HR 2.02; 95% CI 1.32–3.11) within the H arm, but not within the T-DM1 arm (HR 1.01; 95% CI 0.56–1.83). High vs low PD-L1 expression was associated with better outcome within the H arm (HR 0.66; 95% CI 0.44–1.00) but not within the T-DM1 arm (HR 1.05; 95% CI 0.59–1.87). Similar trends were observed in the checkpoint inhibitor subgroups. Conclusions: These exploratory analyses provide the first data on the relationship between biomarker expression in residual disease after HER2-targeted therapy and outcomes. PIK3CA mut status did not influence outcomes with H or T-DM1. T-DM1 benefit appeared to be independent of all biomarkers assessed. Clinical trial information: NCT01772472 .
LINC00173.v1 promotes angiogenesis and progression of lung squamous cell carcinoma by sponging miR-511-5p to regulate VEGFA expression
Authors: Jiarong Chen, Aibin Liu, Zhihui Wang, Bin Wang, Xingxing Chai, Wenjie Lu, Ting Cao, Ronggang Li, Minyan Wu, Zhuming Lu, Wenguang Pang, Lin Xiao, Xiangmeng Chen, Yan Zheng, Qiong Chen, Jincheng Zeng, Jun Li, Xin Zhang, Dong Ren, Yanming Huang
Journal: Molecular Cancer (2020)

Abstract Background Anti-angiogenic therapy represents a promising strategy for non-small-cell lung cancer (NSCLC) but its application in lung squamous cell carcinoma (SQC) is limited due to the high-risk adverse effects. Accumulating evidence indicates that long noncoding RNAs (lncRNAs) mediate in tumor progression by participating in the regulation of VEGF in NSCLC, which might guide the development of new antiangiogenic strategies. Methods Differential lncRNA expression in SQC was analyzed in AE-meta and TCGA datasets, and further confirmed in lung cancer tissues and adjacent normal tissues with RT-qPCR and in-situ hybridization. Statistical analysis was performed to evaluate the clinical correlation between LINC00173.v1 expression and survival characteristics. A tube formation assay, chick embryo chorioallantoic membrane assay and animal experiments were conducted to detect the effect of LINC00173.v1 on the proliferation and migration of vascular endothelial cells and tumorigenesis of SQC in vivo. Bioinformatics analysis, RNA immunoprecipitation and luciferase reporter assays were performed to elucidate the downstream target of LINC00173.v1. The therapeutic efficacy of antisense oligonucleotide (ASO) against LINC00173.v1 was further investigated in vivo. Chromatin immunoprecipitation and high throughput data processing and visualization were performed to identify the cause of LINC00173.v1 overexpression in SQC. Results LINC00173.v1 was specifically upregulated in SQC tissues, which predicted poorer overall and progression-free survival in SQC patients. Overexpression of LINC00173.v1 promoted, while silencing LINC00173.v1 inhibited the proliferation and migration of vascular endothelial cells and the tumorigenesis of SQC cells in vitro and in vivo. Our results further revealed that LINC00173.v1 promoted the proliferation and migration of vascular endothelial cells and the tumorigenesis of SQC cells by upregulating VEGFA expression by sponging miR-511-5p. Importantly, inhibition of LINC00173.v1 via the ASO strategy reduced the tumor growth of SQC cells, and enhanced the therapeutic sensitivity of SQC cells to cisplatin in vivo. Moreover, our results showed that squamous cell carcinoma-specific factor ΔNp63α contributed to LINC00173.v1 overexpression in SQC. Conclusion Our findings clarify the underlying mechanism by which LINC00173.v1 promotes the proliferation and migration of vascular endothelial cells and the tumorigenesis of SQC, demonstrating that LINC00173.v1-targeted drug in combination with cisplatin may serve as a rational regimen against SQC.
Primary extranodal non-Hodgkin lymphoma: Clinical characteristics and outcome.
Authors: Tara Rajendran, Krishna Prasad
Journal: Journal of Clinical Oncology (2020)

e20027 Background: According to the National Cancer Registry Program, the Indian Council of Medical Research reports that the estimated Incidence rate of Non-Hodgkins Lymphoma in India is 2-3 per 100,000 people. The incidence rate of extranodal Non-Hodgkins Lymphoma (NHL) in Asia is higher than that of the United States. We illustrate a single center review of the clinical characteristics of all the primary extranodal NHL. Methods: We retrospectively identified patients diagnosed with primary extranodal NHL out of 269 NHL patients diagnosed at the department of medical oncology, Kasturba Medical College hospital, Mangalore, India from August 1999 and September 2015. Results: A total of 43 patients(15.9%) with primary extranodal NHL were identified out of which 25 patients (58%) were male with a median age of 49 years (5-92). 11patients (25%) had tonsil as the extranodal location and 10 patients (23%) had musculoskeletal involvement. Lung, thyroid, ovary, nasopharynx, gastrointestinal, paranasal sinuses and central nervous system were the other sites. 17 patients (39.5%) were presented at stage 4. The most common subtype was diffuse large B cell Lymphoma (DLBCL)-25 patients (58%). 2 patients had HIV infection. Some CD 20+ patients could not afford the cost of Rituximab and hence resorted to the CHOP regimen for 6 cycles. Rest received RCHOP 6-8 cycles depending on the stage and response. Follicular Lymphoma patient received 6 cycles of RCHOP and Rituximab maintenance for 12 cycles once in 2 months. Burkitts lymphoma patient received MCP 842. 3 patients denied treatment. 6 patients had recurrence who received DHAP +/- Rituximab or ICE +/- Rituximab. 1 patient-reported progression treated with supportive care. 6 patients (14%) died and 22 (55%) patients attained complete remission. Conclusions: In our cohort, DLBCL was the most common subtype and tonsil, the most involved site. The prognosis was impacted by the stage at which the patient was presented, HIV infections and the higher cost of Rituximab. Primary extranodal NHL must be considered in the differential diagnosis as the current treatments can achieve complete remission.
Changes of anti-thyroid drug on bone mineral density and bone turnover parameters in patients with Graves disease
Authors: Quanxia Gu, Donghui Yang
Journal: BMJ (2014)

To explore the changes of anti-thyroid drug (ATD) on bone mineral density and bone turnover parameters in patients with Graves disease (GD). Compared with the healthy controls during the same period, the serum levels of alkaline phosphatase (AKP) and bone gla protein (BGP) in GD patients significantly increased at pre-treatment and after normal thyroid by treatment(P 0.05); BMD significantly decreased at pre-treatment and Month 12 after normal thyroid (P 0.05). GD could affect bone metabolism and thyroid hormone might accelerate bone metabolism directly.


Key words: 
Thyroid diseases; Bone diseases, metabolic
Maladaptive social norms, cultural progress, and the free-energy principle
Authors: Matteo Colombo
Journal: Behavioral and Brain Sciences (2020)

Abstract Veissière and collaborators ground their account of culture and social norms in the free-energy principle, which postulates that the utility (or adaptive value) of an outcome is equivalent to its probability. This equivalence would mean that their account entails that complying with social norms has always adaptive value. But, this is false, because many social norms are obviously maladaptive.
Lung cancer chemotherapy and radiotherapy toxicity in patients with HIV.
Authors: Tinaye Mutetwa, Deborah Catherine Marshall, Sadiq Rehmani, Paz Polak, Keith Magnus Sigel
Journal: Journal of Clinical Oncology (2020)

e13616 Background: Lung cancer is the leading cause of cancer death for people living with HIV (PWH), and this group experiences lung cancer outcome disparities for unclear reasons. To better understand these disparities, we explored potential differences in adverse events since the start of chemotherapy, or radiation therapy (RT), among PWH with stage I-IIIA non-small cell lung cancer (NSCLC). Methods: Our matched case-cohort study used data from SEER-Medicare data on stage I-IIIA NSCLC diagnosed between 2000 and 2013. We identified 809 early stage NSCLC patients with HIV; 40 were treated with chemotherapy and 60 with RT. For each therapy type, a PWH case was matched, by age, sex, and cancer stage to 10 controls with no evidence of HIV infection. Outcome Measures: Acute severe chemotherapy or RT toxicity ascertained by a relevant inpatient diagnosis within 6 months of chemotherapy initiation or chronic toxicities from outpatient diagnostic codes within 24 months. We also evaluated overall (all-cause) and lung cancer-specific survival. Results: Among hematologic toxicities, PWH treated with chemotherapy were more than twice as likely to develop severe anemia [odds ratio [OR] = 2.3 (95% confidence interval [95% CI]: 1.2-4.6)]; but not neutropenia or thrombocytopenia (both p &gt; 0.06). Among patients receiving chemotherapy, HIV was not associated with any other severe acute toxicities including fever, infection, nausea, renal dysfunction, and septicemia. For chronic complications, PWH had increased risk of neuropathy (OR 4.2; 95% CI: 1.3-13.6). Overall, HIV was associated with an increased count of chemotherapy complications seen per patient [p = 0.02]. PWH receiving chemotherapy had worse all-cause mortality (hazard ratio (HR) = 1.7; 95% CI: 1.2-2.4) and higher lung cancer-specific mortality (HR 1.8; 95% CI: 1.2-2.7) compared to uninfected persons after adjusting for treatment with surgery. In contrast, HIV was not significantly associated with severe RT complications (esophagitis, pneumonitis or hemoptysis), although all-cause mortality (HR 1.5; 95% CI: 1.1-2.0) and lung-cancer specific mortality (HR 1.5; 95% CI: 1.1-2.0) were higher among PWH receiving RT after adjusting for treatment with surgery. Conclusions: Antiretroviral-era PWH with early stage lung cancer experienced more frequent complications after chemotherapy but not radiotherapy compared to matched uninfected persons. These toxicities may have led to treatment alterations potentially contributing to outcome disparities seen in this high-risk group.
Response to: ‘Autoantibodies and interstitial lung disease in rheumatoid arthritis: towards a ‘mix-and-match’ approach’ by Alunno<i>et al</i>
Authors: Raul Castellanos-Moreira, Sebastian Cruz Rodríguez-García, Isabel Haro, Raimon Sanmarti
Journal: Annals of the Rheumatic Diseases (2020)

Relationship between rheumatoid arthritis and interstitial lung disease is a 'two-way street'.Response to: 'Autoantibodies and interstitial lung disease in rheumatoid arthritis: towards a 'mix-and-match' approach' by Alunno et alWe welcome the comments by Alunno et al on our article about the association between anticarbamylated protein antibody (anti-CarP) specificities and rheumatoid arthritis-associated interstitial lung disease (RA-ILD). 1The authors proposed a 'mix and match approach' consisting of the assessment of various antibody specificities at RA diagnosis with the aim of predicting the development of ILD. 2 We believe this hypothesis is reasonable, considering that different antimodified protein antibodies (AMPA) including anti-CarP, anticitrullinated and antiacetylated protein antibodies (ACPA and anti-AceP, respectively) have been associated with RA-ILD. 1 3 4 Furthermore, a greater number of coexisting specificities of a single AMPA have been found in patients with RA-ILD. 3 5 The prevalence of ILD and its risk factors fluctuate between RA cohorts, partially due to differences in the screening methods, the population examined, and the defining criteria used.Although these factors were controlled in our study, there were differences in some baseline features between the main population and the replication sample, as pointed out by Alunno et al. 2 This may be due to the small sample size of the replication sample or because ILD screening and diagnosis was ultimately based on physician's criteria based on the ILD committee dictates from two hospitals.However, our final model was fitted after adjusting for these features and so they did not affect the results.Recently, Zhu et al reported a higher proportion of anti-CarP in Chinese patients diagnosed with RA-ILD compared to RA controls without ILD (53% vs 16%). 6Their findings are consistent with and enhance the external validity of our observations.However, larger multiethnic studies are still required.We consider the association between ILD and RA is a 'twoway street'.It should be considered that: (1) ILD may be present before or around RA onset in one in three patients 7 and (2) ACPA have been found in more than 20% of patients with idiopathic pulmonary fibrosis (IPF), 8 of whom approximately onethird subsequently may develop RA. 9 Thus, the 'mix and match approach' should be considered in RA and IPF.We believed a broader view (eg, multidisciplinary ILD committees) on the issues implied in the relation between ILD and RA should be considered in the design of future prospective collaborative studies.
Some issue about diagnosis and treatment of epilepsy which should be concerned by general practitioners
Authors: 吴逊
Journal: BMJ (2007)

癫痫是常见的神经系统疾病,是大脑神经元异常放电导致的一过性脑功能障碍,其临床表现为发作性、重复性的症状,根据放电部位不同可以有多种发作性症状.国际抗癫痫联盟(International League Against Epilepsy,ILAE)于2005年对癫痫的定义作了修定:由于大脑的易感性产生癫痫发作,并且引起神经生物学、认知、心理学以及社会方面的后果。