tbuckley/cabot-search huggingface dataset:
Abstract MP030: The Association Between Objectively Measured Sleep, Physical Activity and Sedentary Behaviour on Cardiorespiratory Fitness and Health in 9 - 11 Year Old New Zealand Children
Authors: Paula M Skidmore, Katherine E Black, Sheila Skeaff, Lee Stoner, Robin Quigg, Harriet A Harrex, Pouya Saeedi, Brittany Davison, Kim Meredith-Jones
Journal: Circulation (2017)

Background: The role of activity, sedentary behaviour and sleep in cardiorespiratory fitness (CRF) or cardiovascular health, has been primarily studied in adults. Therefore we assessed the hypothesis that longer sleep duration, more time spent in moderate to vigorous activity (MVPA), less sedentary time and a lower ratio of sedentary time to MVPA (Sedentary: MVPA) would be associated with higher CRF and lower pulse wave velocity (PWV) in children aged nine to 11 years from Dunedin, New Zealand. Methods: A cross-sectional study. Information on demographics and lifestyle was collected by questionnaire. Data on sleep, sedentary and MVPA time were collected using Actigraph wGT3X-BT accelerometers, worn over eight days. PWV was obtained using the SphygmoCor Xcel. VO 2 max values, from a multi-stage 20-metre shuttle run test, were used as the measure of CRF. Generalised estimating equations were undertaken to investigate relationships between accelerometer derived variables and CRF and PWV separately in 404 participants. Analyses were adjusted for age, socioeconomic status, ethnicity and age and sex specific BMI Z scores. Results: Mean (SD) VO 2 max was 47.5 (4.1) Ml/Kg/min for girls and 49.9 (5.20) for boys and mean (SD) PWV was 5.72 (0.79) for girls and 5.85 (0.79) for boys. In multivariate models, a one hour increase in sedentary time was associated with a 0.81 (CI: -1.19, -0.42) Ml/Kg/min increase in VO 2 max in all participants. In boys only, a one hour increase in MVPA associated with a 3.50 (CI: 2.76, 4.20) Ml/Kg/min increase in VO 2 max. Sedentary: MVPA was associated with lower VO 2 max in boys and girls. Sedentary time (β 0.15 m/s per hour increase, CI: 0.02, 0.27) and MVPA (β 0.25 m/s per hour decrease, CI: 0.04, 0.46) were only significantly associated with PWV in boys. No significant assocaitions were seen between sleep and CRF or PWV. Conclusions: In conclusion, sedentary behavior, MVPA and Sedentary: MVPA were both associated with CRF and PWV. Our results suggest that future interventions aimed at improving heart health in this age group need to target both increasing physical activity and reducing sedentary time. Funding sources: The National Heart Foundation of New Zealand and The University of Otago.
Why not be pluralists about explanatory reduction?
Authors: Kathryn Tabb
Journal: Behavioral and Brain Sciences (2019)

Abstract Borsboom et al. convincingly argue that, from their symptom network perspective, mental disorders cannot be reduced to brain disorders. While granting that network structures exist, I respond that there is no reason to think they are the only psychiatric phenomena worth explaining. From a pluralist perspective, what is required is not a full-scale rejection of explanatory reductionism but a critical attention to the circumstances of its application.
Abstract P087: Dietary Flavonoids Intake Reduced the C-Reactive Protein Concentration, Yet Did Not Associate With the Risk of Metabolic Syndrome Among Taiwanese Adults: A Representative National Study
Authors: Kuo-Liong Chien, Jui Wang, Cheng-Tzu Hsieh
Journal: Circulation (2019)

Background and Hypothesis: Evidence about the role of various flavonoids in atherosclerosis prevention was still controversial. We investigated the association between dietary flavonoid intakes and the level of C-reactive protein as well as the risk of metabolic syndrome among a national representative sample from the Nutrition and Health Surveys in Taiwan during 2005 and 2008. Methods: A total of 2439 adult participants (51.9% women, 54.3±17.6 years) who provided detailed food frequency questionnaire and clinical as well as biochemical data were recruited. We measured total and six flavonoids, including flavone, flavonol, flavanones, flavan_3_ol, anthocyanidins, and isoflavones from the USDA Database for the Flavonoid Content of Selected Foods. C-reactive protein was measured by nephelometry. Definition of metabolic syndrome was followed using the Third Adult Treatment Panel criteria, with a modification of the criteria for Asian population. Results: The mean dietary total flavonoid intake was 142.6±306.0 mg/day (median, 42.9, interquartile range, 11.2-137.2 mg/day). C-reactive protein was inversely related to various dietary intakes, including flavone, flavonol, flavan_3_ol, anthocyanidins, and total flavonoids (coefficients ranging from -0.04 to -0.06, all P &lt;0.05). After adjusted for age and gender, participants among the highest quantile of dietary flavonol intake has a significant lower C-reactive protein concentration (-0.075±0.037 mg/dL), compared with those among the lowest quartile ( P test for trend, 0.07). Participants among the highest total flavonoid intake have a lower C-reactive protein level (-0.096±0.037 mg/dL, P test for trend, 0.046). With regards to the risk of the metabolic syndrome, a higher dietary flavonoid intake was not associated with metabolic syndrome status (adjusted odds ratio, 0.96, 95% confidence interval, 0.73-1.89 for flavonol, P test for trend, 0.57). Conclusions: We demonstrated that dietary flavonoid intakes were inversely associated with the C-reactive protein concentration. Further intervention trials are warranted to elucidate the biological mechanism of protective effect of flavonoids.
Impact of total cisplatin dose on outcomes in locally advanced oropharyngeal squamous cell carcinoma.
Authors: Dorothy L. Uhlman, Allison Y. Ye, Minette Lagman, Jonn Wu, Catherine F Poh, Cheryl Ho
Journal: Journal of Clinical Oncology (2015)

e17035 Background: De-intensification of chemoradiotherapy is being explored in HPV+ oropharyngeal squamous cell carcinoma (SCC). We evaluated the impact of total cisplatin dose on disease free survival (DFS) and overall survival (OS) in locally advanced oropharygeal SCC. Methods: A retrospective chart review was conducted of all patients referred to four centers at the BC Cancer Agency with stage III-IVB oropharyngeal SCC treated with concurrent, curative intent cisplatin and radiotherapy (XRT) from September 2008- September 2011. Results: 185 patients were identified. Baseline characteristics: male 85%, median age 57, ECOG performance status (PS) 0-1 95%, stage III, 19%, IVA 73% and IVB 8%. Smoking status: never or < 10 pack years, 40%, > 10 pack years, 49%, unknown 11%. P16 staining: positive 71%, negative 15%, unknown 14%. Ang risk classification (RC): low 40%, intermediate 34%, high 12%, unknown 14%. Treatment planned: 70 Gy/35 fractions 90%, 60 Gy/25 9% and 66 Gy/33 1%. Total planned cisplatin: 300 mg/m2 in 67%, 150 mg/m2 in 31% and other in 2%. 96% of pts received all of the planned XRT and 50% of patients received all the planned cisplatin. Actual total cisplatin dose delivered was < 200 mg/m2 in 41%, 200-299 mg/m2 in 31% and 300 mg/m2 in 28%. Grade > = 3 toxicity (oral mucositis, nausea and vomiting, radiation dermatitis) was noted in 58%. Clinical complete remission was obtained in 94% of patients. 3 yr DFS and OS were 70% and 75% for total cisplatin dose < 200 mg/m2, 81% and 85% for 200-299 mg/m2 and 86% and 90% for 300 mg/m2 (p = 0.075 for DFS, 0.028 for OS). Multivariate analysis demonstrated that poor PS, higher RC, lower XRT dose and total cisplatin dose 200-299 mg/m2, were associated with recurrence. Poor PS, higher RC, total cisplatin dose 200-299 mg/m2 but not XRT dose, were associated with higher risk of death. Conclusions: Our retrospective study suggests that higher total cisplatin dose was associated with better OS in a population with predominantly low to intermediate risk oropharyngeal SCC.
Elevated CD36 expression correlates with increased visceral adipose tissue and predicts poor prognosis in ccRCC patients.
Authors: Wen-Hao Xu, Yuan-Yuan Qu, Jun Wang, Hai-Liang Zhang, Dingwei Ye
Journal: Journal of Clinical Oncology (2019)

571 Background: Growing evidence has proved obesity one of the confirmed important etiologic indicators for renal cell carcinoma (RCC). CD36 is underpinned to be involved in adipose absorption, but its role in clear cell renal cell carcinoma (ccRCC) remains unclear. This study aimed to investigate the mRNA expression of CD36 in anthropometric measures of adipose tissue and defining its value in predicting prognosis in ccRCC patients. Methods: Real-Time qPCR was detected from 367 paired ccRCC and adjacent normal tissues. Distributions of categorical clinical-pathological data together with levels of CD36 expression were compared with χ 2 -test. Subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) were measured by MRI. Pearson’s correlation coefficient was utilized to quantify relations between body mass index (BMI), VAT%, SAT and CD36 expression respectively. Cox regression analysis were developed to address the influence of independent factors on prognostic value. Gene Set Enrichment Analysis (GSEA) was performed to select related genes and pathways from TCGA database. Results: In the current study, we demonstrated that CD36 mRNA was highly expressed in ccRCC tissues, and was found significantly increased in patients with advanced TNM stage ( p= 0.003, p&lt; 0.001, p&lt; 0.001), and high VAT% ( p= 0.004). Pearson’s correlation coefficient indicated CD36 amplification positively correlated with BMI ( r= 0.117, p= 0.025), VAT% ( r= 0.465, p&lt; 0.001), while negatively with SAT ( r= -0.296, p= 0.002). Furthermore, ccRCC patients with elevated CD36 expression held shorter PFS and OS, with HR of 4.873 (3.300-7.196, p&lt; 0.001) and 4.610 (2.956-7.189, p&lt; 0.001). In 104 cases whose MRI scans were available, VAT was significantly correlated with poor PFS and OS. Significant genes were obtained from GSEA, and CD36 was found involved in the most significant pathways including fatty acid metabolism, angiogenesis and TGF-β signaling pathways. Conclusions: In conclusion, our study first reveal that elevated CD36 mRNA expression is positively correlated to distribution of abdominal adipose, particularly VAT%, which, in addition, notably predicts poor prognosis in ccRCC patients.
Review: Extra physical therapy improves some outcomes by a small amount in acute or subacute health conditions
Authors: Dinesh Kumbhare
Journal: Annals of Internal Medicine (2019)

Source Citation Peiris CL, Shields N, Brusco NK, Watts JJ, Taylor NF. Additional physical therapy services reduce length of stay and improve health outcomes in people with acute and subacute conditions: an updated systematic review and meta-analysis. Arch Phys Med Rehabil. 2018;99:2299-312. 29634915
Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study
Authors: Li Wei, Edward Chia-Cheng Lai, Yea-Huei Kao-Yang, Brian R Walker, Thomas M MacDonald, Ruth Andrew
Journal: BMJ (2019)

Abstract Objective To investigate the incidence of new onset type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors (dutasteride or finasteride) for long term treatment of benign prostatic hyperplasia. Design Population based cohort study. Setting UK Clinical Practice Research Datalink (CPRD; 2003-14) and Taiwanese National Health Insurance Research Database (NHIRD; 2002-12). Participants Men in the CPRD who received dutasteride (n=8231), finasteride (n=30 774), or tamsulosin (n=16 270) were evaluated. Propensity score matching (2:1; dutasteride to finasteride or tamsulosin) produced cohorts of 2090, 3445, and 4018, respectively. In the NHIRD, initial numbers were 1251 (dutasteride), 4194 (finasteride), and 86 263 (tamsulosin), reducing to 1251, 2445, and 2502, respectively, after propensity score matching. Main outcomes measure Incident type 2 diabetes using a Cox proportional hazard model. Results In the CPRD, 2081 new onset type 2 diabetes events (368 dutasteride, 1207 finasteride, and 506 tamsulosin) were recorded during a mean follow-up time of 5.2 years (SD 3.1 years). The event rate per 10 000 person years was 76.2 (95% confidence interval 68.4 to 84.0) for dutasteride, 76.6 (72.3 to 80.9) for finasteride, and 60.3 (55.1 to 65.5) for tamsulosin. There was a modest increased risk of type 2 diabetes for dutasteride (adjusted hazard ratio 1.32, 95% confidence interval 1.08 to 1.61) and finasteride (1.26, 1.10 to 1.45) compared with tamsulosin. Results for the NHIRD were consistent with the findings for the CPRD (adjusted hazard ratio 1.34, 95% confidence interval 1.17 to 1.54 for dutasteride, and 1.49, 1.38 to 1.61 for finasteride compared with tamsulosin). Propensity score matched analyses showed similar results. Conclusions The risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5α-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Additional monitoring might be required for men starting these drugs, particularly in those with other risk factors for type 2 diabetes.
Incidence and pathological features of metachronous bladder cancer in prostate cancer patients treated with brachytherapy or radical prostatectomy in a single institution.
Authors: Kotaro Obayashi
Journal: Journal of Clinical Oncology (2019)

111 Background: Although previous studies have reported that the incidence of metachronous bladder cancer (MBC) is not significantly different after brachytherapy (BT) compared to radical prostatectomy (RP), few studies have reported differences in the pathological features (PF) of MBC between them. This study was conducted to clarify differences in the incidence and PF of MBC between BT and RP in our hospital. Methods: We reviewed 504 patients treated with BT and 471 referred patients treated with RP from 2006 to 2017 in our hospital. We checked the incidence of MBC in all patients and examined the PF including the tumor number, location within the bladder, histology, and time from BT or RP to the occurrence. The chi-square test and Mann-Whitney U test were performed to analyze the differences between the two groups. Results: After a median follow-up time of 66 months, a total of 8 cases of BC occurred in the BT group (1.6 %) and 5 in the RP group (1.1 %). The median time from initial treatment to the occurrence of MBC was 56 months (12-121) in BT and 71 months (4-126) in RP (p = 0.622). Average tumor number was not significantly different (BT:1.38, RP: 2.2, p = 0.265). The incidence of MBC in each location within the bladder for BT vs. RP was 4 vs 0 in the right wall, 3 vs 0 in the left wall, 0 vs 3 in the posterior wall, 0 vs 2 in the dome, and 1 vs 0 in the trigone. The incidence in the lateral wall was significantly higher in BT than in RP (p = 0.00466). There were 3 muscle-invasive cases in BT and 1 case in RP (p = 1.00). High-grade urothelial cancer occurred more in BT 8 than in RP 1 (p = 0.00699). Conclusions: The risk of MBC after BT appeared to be equivalent to patients after RP. MBC after BT occurred more in the lateral wall with worse PF compared to those after RP.
Real Life Dates of Chronic Lymphocytic Leukemia (CLL) in Germany. Interim Analysis of 234 Consecutively New Diagnosed Patients in a German Epidemiological-Clinical Register
Authors: Dietrich Kämpfe, Harald Stein, Roshanak Bob, Sebastian Böttcher, Joerg Brenn, Agnes Knopp, Thomas Haverkamp, Christoph Schulte, Detlef Haase
Journal: Blood (2018)
Neoadjuvant chemotherapy utilization in muscle-invasive bladder cancer: Increasing yet inappropriate use?
Authors: Yaw A. Nyame, Sarah K Holt, Brian Winters, Sarah P. Psutka, Atreya Dash, George R Schade, Daniel W. Lin, Evan Y. Yu, John L. Gore, Jonathan L. Wright
Journal: Journal of Clinical Oncology (2019)

441 Background: Neoadjuvant cisplatin-based chemotherapy (NAC) is associated with improved overall survival in patients with muscle-invasive bladder cancer (MIBC); however, utilization nationally has been low. Over the past decade, the use of NAC has increased to approximately 20% of patients with MIBC. We investigate whether this increase in NAC is with appropriate cisplatin-based regimens using registry data. Methods: This is a population-based analysis of linked SEER-Medicare data from 2004-2011. We identified 4,534 patients with cT2-4N0-1 bladder cancer undergoing cystectomy. Specific chemotherapy drugs administered were identified using pharmacy records. The cohort was stratified into three groups, standard of care (SOC: i.e., appropriate cisplatin-based chemotherapy), non-SOC, and no NAC. Descriptive statistics were performed to compare each group and multivariate logistic regression performed to determine factors associated with receiving SOC NAC. Results: Over the study period, 694/4534 (15.3%) of patients in the study received NAC, increasing from 11.0% in 2004 to 24.8% in 2011. From 2004-2011, 345/694 (49.7%) of patients who were given NAC received a non-SOC regimen. Among patients that received non-SOC NAC, the most common regimens included gemcitabine-carboplatin in 170/345 (49.3%), gemcitabine monotherapy 73/345 (21.2%) carboplatin monotherapy in 51/345 (14.8%), cisplatin monotherapy 29/345 (8.4%), and MVA with carboplatin 3/345 (0.8%). On multivariate analysis, age (OR 0.91[95% CI 0.88-0.94]) and moderate/severe renal disease (OR 0.2[95% CI 0.08-0.51]) were negatively associated with SOC NAC. The year of diagnosis (OR 1.32[95% CI 1.23-1.42]) was positively associated with the receipt of SOC NAC in the cohort. Conclusions: Although NAC for MIBC has increased, nearly half of these patients are not receiving SOC cisplatin-based regimens. This underscores the importance of better identifying patients eligible for neoadjuvant therapy, the need for appropriate drug selection which may be facilitated through centers of excellence and multidisciplinary clinics, and the need for more clinical trials for cisplatin ineligible patients.
Abstract P275: Objective Short Sleep Duration Increases the Risk of Cancer Mortality Associated With Cardiovascular and Cerebrovascular Disease
Authors: Julio Fernandez-Mendoza, Fan He, Alexandros N Vgontzas, Duanping Liao, Edward O Bixler
Journal: Circulation (2019)

Introduction: Cardiovascular/cerebrovascular diseases (CBVD) and cancer share cardiometabolic risk factors (CMR) and underlying immune-related pathophysiologic mechanisms. Short sleep duration is a risk factor for CBVD, while the latter a predictor of cancer mortality. However, the role of sleep duration in predicting cancer mortality in the context of CBVD has not been systematically examined. Hypothesis: We hypothesized that objective sleep duration is an effect modifier of the impact of CMR and CBVD on cancer mortality. Methods: We addressed this question in the Penn State Adult Cohort, a random, general population sample of 1,654 men and women (47.5 ± 12.3 years) who were studied in the sleep laboratory with 8-hour polysomnography (PSG) at baseline and followed-up for 19.2 ± 5.2 years for cause of death. A total of 512 (30.9%) of subjects died during the follow-up, of whom 131 died of cancer. At baseline, the presence of CBVD was defined by a clinical history of heart disease and/or stroke, while the presence of CMR as stage 2 hypertension (blood pressure ≥140/90mmHg or anti-hypertensive medication) and/or type 2 diabetes (fasting glucose ≥126 mg/dL or treatment for diabetes). PSG-measured short sleep duration was defined as &lt; 6 hours of sleep at baseline. Results: We tested the interaction between CMR/CBVD and PSG sleep duration on mortality using Cox proportional hazard models controlling for multiple potential confounders (p-value=.05). Consistent with this significant effect modification, the hazard ratios (95%CI) of cancer mortality associated with CMR and CBVD were 0.98 (0.54-1.79) and 0.55 (0.18-1.64) among individuals who slept ≥ 6 hours and 2.53 (1.23-5.22) and 2.92 (1.28-6.65) among individuals who slept &lt; 6 hours. Conclusions: The risk of cancer mortality is significantly increased in adults with CMR or CBVD when they demonstrate objective short sleep duration. Future studies should disentangle the underlying mechanisms (e.g., immune suppression and chronic low-grade inflammation) of the association between short sleep and cancer incidence and mortality in individuals with or at-risk of CBVD.
Postoperative long-term prognosis of localized renal cell carcinoma after partial or radical nephrectomy: Analysis of cancer metastasis and deaths during a more than five-year follow-up.
Authors: Sang Hyun Park, Taek Sang Kim, Jae Young Joung, Sung Han Kim, Jinsoo Chung
Journal: Journal of Clinical Oncology (2019)

604 Background: We performed a long-term follow-up study to evaluate the survival and metastatic outcomes of non-metastatic renal cell carcinoma (RCC) after curative removal of tumor. Methods: We retrospectively reviewed the clinical and pathological features of 5434 patients with localized renal cell carcinoma admitted to five Korean tertiary-care institutions between 2000 and 2012, who had undergone curative surgeries with partial or radical nephrectomy with/without lymph nodal dissection. The patients below the age of 19 years (N=9) with benign histology (N=24), and with no follow-up records (N=540) were excluded. A total of 4861 patients, followed-up for at least 1 year after the surgery, were enrolled finally. The deaths were defined as intraoperative, postoperative or RCC-related deaths. We analyzed the metastasis-free survival, cancer-specific survival, and overall survival outcomes according to the pathological stages. Results: The median age of patients at the time of surgery, male-to-female ratios, median follow-up duration, overall survival and metastasis-free survival times were 56 years (range: 19-94 years), 3471/1390 (71.4%/28.6%), 33.7 months (range: 12-297 months), 175.1 months (12-297.1 months), and 61 months (range: 12-94 months), respectively. A total of 518 (10.7%) deaths, including 338 (7.0%) RCC-related death and 164 (3.3%) deaths related to other causes were reported. Metastasis and recurrences were observed in 140 (2.9%) and 462 (9.5%) patients, respectively. The respective pathologic T1/2/3/4/x and N1 stages, namely, 3757/389/644/57/6 (77.3/8.0/13.3/1.2/0.1%) and 133 (2.7%) were observed. The rates of histological types of clear cell papillary/ chromophobe/ collecting duct/ unclassified/ MLCRCCLMP/ mixed cell papillary/ unknown were 83.4%/ 1.5%/ 7.1%/ 0.4%/ 1.1%/ 0.5%/ 0.2%/ 0.3%/ 0.1%/ 5.3%. The 10-year metastasis-free survival rate was 86.0% including 100%, 91.0%, 64.1%, and 11.8% incidence for stages I, II, III, and IV, respectively. Conclusions: The long-term survival was seen among patients who underwent nephrectomy for non-metastatic renal cell carcinoma.