tbuckley/cabot-search huggingface dataset:
Awareness of diagnosis and treatment for chronic hepatitis B among general practitioners at communities and effectiveness of its intervention
Authors: Xue-fei Duan, Mei-mei Tian, Yun-ru Li, Xiao-ling Fan
Journal: BMJ (2010)

Totally, 102 general practitioners (GPs) from 40 community health-care service centers in a district of Beijing were investigated for their awareness of diagnosis, treatment and prevention for chronic  B and evaluating effectiveness of their training with self-designed questionnaire before and after professional training.Before training, higher awareness of knowledge about prevention for  B had been achieved in GPs, such as hepatitis C is communicable (78/102, 76.5% ), hepatitis B can be prevented by protective antibody ( 76/102, 74.5% ), whereas only 3.9% ( 4/102 ) of GPs knew indications of antiviral therapy for chronic  B, 4.9% (5/102) could describe complications of decompensated cirrhosis and 19.6% (20/102) knew methods for screening primary hepatocellular carcinoma.After training, their awareness increased significantly to 93.1% (95/102), 49.0% (50/102)and 86.3% (88/102), respectively (all P ＜0.01 ).Now, GPs' knowledge about diagnosis and treatment for  B is still insufficient at community health-care centers and professional training can improve their awareness.It is an important assurance for patients with chronic  B to be better managed in both of specialized hospitals and community health-care centers by enhancing professional training for GPs indiagnosis and treatment for  B.

Key words: 
Physicians,family;  Hepatitis B,chronic
北京市安定门地区10年传染病发病分析
Authors: 马燕茹, 金文婷, 王丽君
Journal: BMJ (2007)

对辖区1996年至2005年传染病发病情况进行分析. 1.资料与方法:资料来源于安定门地区常住人口疫情报告(各年常住人口数见表1).按年份、性别、年龄、季节进行发病数(率)和定基比的统计,数据分析采用u检验。
A study on seasonal variation of blood pressure in patients with essential hypertension
Authors: Xing-bin Gao, Tong-de Wang, Chang-lan Cao, De-yi Liu, You-xiang Li, Hai-feng Sun, Li-li Song, Jing-wei Zhang
Journal: BMJ (2010)

Objective To study seasonal variation of blood pressure (BP) in patients with essential hypertension (EH) and its association with meteorological elements. Methods In total, 1800 patients with essential hypertension were recruited by cluster sampling from three townships and towns in Qingzhou,Shandong province, 1155 men and 645 women, with an average age of 61.3 years (ranging from 29 to 85years). BP was measured for all of them in sitting position at 8:00 in the morning every seven to 14 days during July 2008 to June 2009. Local meteorological data were collected accordingly such as temperature,humidity and atmospheric pressure, and multivariate regression analysis was performed to show their association. Results In general, BP in patients with EH presented a decreasing trend during the first half year of observation, with the lowest in the summer ( May to August). From September to October, their BP began to increase gradually, and reached the peak in the winter ( November to February nest year). There was significant difference in systolic BP (SBP) and diastolic BP (DBP) between various seasons (Pspring-summer = 0.002 and 0.000, Pwinter-spring = 0.001 and 0.000, Psummer-autumn = 0.045 and 0.000,Psummer-winter =0. 000 and 0. 000, Pautumn-winter =0. 000 and 0. 000, respectively), except for those between the spring and autumn. Both SBP and DBP reversely associated with outdoor air temperature and room temperature(beta= -0.08, t = -2.39, P ＜0.05 and beta = -0.24, t = -6.21, P ＜0.01,respectively), (beta = -0.08, t = -2.39, P ＜0.05 and beta = -0.24, t = -6.21, P ＜0.01,respectively). Conclusions BP in patients with EH reveals seasonal variation, with the lowest in the summer and the highest in the winter and evident fluctuation in the spring and autumn, especially in SBP,which associates with room temperature and their blood vessel elasticity.

Key words: 
Hypertension;  Blood pressure;  Seasons
Safe handling system construction for hazardous drugs (HDs) through the HD exposure surveillance by National Hospital Organization Network in Japan.
Authors: Kenjiro Aogi, Kenichi Watanabe, Takanori Watanabe, Akira Matsui, Yasuyuki Sato, Hiroyuki Yasojima, Yoshinori Yamashita, Shinya Ootsuka, Eriko Tokunaga, Setsuko Anami
Journal: Journal of Clinical Oncology (2020)

e14147 Background: In Japan, much labor has been devoted to handle occupational exposure to hazardous drugs (HDs) after the publication of a guideline for preventing HD exposure on cancer treatments in 2015. However, the safe HD handling systems have not yet constructed in Japanese hospitals. To find out the current HD exposure and construct the safe HD handling system, a multi-institutional surveillance of HD exposure in the National Hospital Organization (NHO) cancer hospitals was commenced from Feb 2016 to Mar 2018. Methods: Thirty-two NHO institutes joined in this survey. HD surveys were performed 3 times in each institute, evaluating cyclophosphamide and fluorouracil exposures using wipe and sampling sheet methods at 18 places in outpatient chemotherapy and pharmacology units. To share information and discuss about HD exposure handling procedures, the study group meeting was held several times. Furthermore, HD handling system in each hospital was evaluated using handling system scoring established by Yoshida in Osaka Institute of Public Health. As an additional study, factors affecting commitment wills of staffs were also evaluated during the safe HD handling system construction using a multiple regression model. Results: As HD control systems constructed, HD exposure in each hospital was improved gradually with construction of the handling system. Staffs’ commitment to their institutes was shown as the result of safety awareness improvement induced by the HD safe handling system construction (standardization coefficient β: 0.346). Conclusions: HD exposures were improved in NHO cancer hospitals through the HD exposure evaluation with constructions of the safe HD handling system.
Application of glycosylated hemoglobin in diagnosis of Chinese diabetic patients
Authors: Li Wu
Journal: BMJ (2016)

随着糖化血红蛋白(HbA1c)在全球范围内标准化检测的建立，2010年美国糖尿病协会(ADA)提出将HbA1c≥6.5%纳入糖尿病诊断标准，标志着HbA1c在糖尿病诊断中的价值被广泛认可。然而，目前有关HbA1c水平的种族差异、在不同人群、不同年龄段的诊断切点及有效性等方面仍存在较多争议。近年来，国内学者对HbA1c在中国人群糖尿病中的诊断价值展开了一系列研究，报道的HbA1c诊断糖尿病的切点大多在6.1%～6.3%之间，普遍低于ADA推荐的标准。本文就根据已有的相关研究对HbA1c在中国人群糖尿病诊断和筛查中的价值进行阐述。
Anticoagulation in patients with mechanical valves during pregnancy
Authors: 孙晓宁, 赵强
Journal: BMJ (2007)

心脏瓣膜置换术后的女性需要抗凝治疗,以防止血栓的发生.一般机械瓣膜置换术后应终生抗凝治疗,生物瓣膜置换术后若为窦性心律,抗凝期可仅数月,但若合并心房颤动、巨大左心房或有栓塞史者,也应持续终身抗凝治疗.妊娠期是特殊生理时期,抗凝治疗有其特殊性,考虑到药物对母婴的影响,选择哪种抗凝剂和抗凝方案尚有争议.现就相关问题做简要综述。
Landscape of RAS variations in 17993 solid tumors: A pan-cancer analysis.
Authors: Hao Wu, Shaoqiang Zhou, Ding Zhang, Jing Zhao, Zhengyi Zhao, Guoqiang Wang, Yuzi Zhang, Longgang Cui, Shangli Cai, Yuezong Bai, Dedian Chen
Journal: Journal of Clinical Oncology (2020)

e15615 Background: RAS family genes (HRAS, KRAS and NRAS) were frequently observed in several tumors. The expression of constitutively active RAS proteins mediated by RAS variations promote the development of tumors. KRAS is an important prognostic and drug resistance biomarker. It would also be a promising drug target. AMG 510 which targeting KRAS G12C showed an ORR of 48% in patients with NSCLC. Several trials which evaluating the efficacy of RAS G12C inhibitor in solid tumors are initiated. Herein, we analyzed the alterations status of KRAS/NRAS/HRAS across diverse solid tumors. Methods: The sing nucleotide variants (SNV) and copy number variants (CNV) data of 17993 Chinese patients from 22 types of cancer were obtained in 3DMed database. Genomic profiling of DNA was performed through a next-generation sequencing with 61 cancer-related genes on tissue. Only the pathogenic mutations and likely pathogenic mutations in clinical significance were rolled into our analysis. Results: Among 17993 pan-cancer patients, the total RAS variants frequency was 23.09%. KRAS was the most frequently altered (90.76% of RAS SNV, 84.70% of RAS CNV), followed by NRAS (6.56% of RAS SNV, 8.58% of RAS CNV) and HRAS (2.68% of RAS SNV, 6.72% of RAS CNV). For the SNV, KRAS were most commonly found in pancreas cancer (685/842, 81.35%), intestine cancer (85/175, 48.57%) and colorectal cancer (1609/3329, 48.33%). NRAS occurred most frequently in melanoma (31/196, 15.82%), colorectal cancer (116/3329, 3.48%) and thyroid cancer (2/60, 3.33%). HRAS were most often found in bladder/urinary tract cancer (46/367, 12.53%), prostate cancer (5/137, 3.65%) and head and neck cancer (7/314, 2.23%). Further analysis among KRAS SNV patients showed that the mutation frequency of KRAS G12C, G12D, G12R and G12V was 9.24%, 34.73%, 3.54% and 21.66%, respectively. A total of 21 in 22 types of solid tumors had KRAS G12C/D/R/V pathogenic or likely pathogenic mutation, which occurred most frequently in colorectal cancer, pancreas cancer and lung cancer. Conclusions: Our results suggested that a variety of solid tumors may harbor KRAS G12C/D/R/V mutation. These patients may benefit from KRAS inhibitors.
Prognostic factors and treatment comparison in small cell neuroendocrine carcinoma of the uterine cervix in the surveillance, epidemiology, and end results database.
Authors: Jinluan Li, Limei Lin, Zongkai Zhang, Yunxia Huang, Qin Lin
Journal: Journal of Clinical Oncology (2020)

e18015 Background: The purpose of this study was to evaluate the impact of treatment modality to survival outcome in small cell neuroendocrine carcinoma of the uterine cervix (SCNEC) using the Surveillance Epidemiology and End Results (SEER) database. Methods: We identified patients with SCNEC from the SEER program during 1981 to 2014and analyzed significant factors for cause-specific survival (CSS) and overall (OS) using Kaplan–Meier survival and Cox regression proportional hazard methods. Results: A total of 503 SCNEC patients were identified. The median follow- up time was 31 months. The 5-year cause specific survival and overall survival were 36.6% and 30.6%, respectively. The FIGO stages I to IV distributions were 189(37.6%), 108 (21.4%),95 (18.9%), and 111 patients (22.1%), respectively. Of the patients with known local treatment strategies, 177 patients (45.9%) were treated with radical surgery and 209 (54.1%) patients underwent primary radiotherapy. In multivariate analysis, local treatment strategies were independent prognostic factors for CSS and OS. The 5- year CSS according to radical surgery and primary radiotherapy were 50.0% and 27.9%, respectively (P &lt; 0.001). The 5-year OS in patients received radical surgery and primary radiotherapy were 57.8%, and 29.6%, respectively (P &lt; 0.001). In FIGO stage I SCNEC, patients treated with radical surgery had superior CSS (P = 0.001) and OS (P = 0.003) than those with primary radiotherapy. However, in FIGO stage II and III SCNEC, there are no differences observed in CSS and OS according to different local treatment strategies. The results also observed that the addition of brachytherapy impact OS (P = 0.002) in FIGO stage III SENCE. The 5-year cause specific survival and overall survival of patients with FIGO IV were only 11.7% and 7.1%, respectively. Conclusions: Small cell neuroendocrine carcinoma of the cervix is a rare disease with aggressive clinical behavior. The results suggested that radical surgery is the optimal local treatment for early-stage SCNEC and combining radiation therapy with brachytherapy should be suitable for patients with advanced stage.
The Stanford Hall consensus statement for post-COVID-19 rehabilitation
Authors: Robert M Barker-Davies, Oliver O"Sullivan, Kahawalage Pumi Prathima Senaratne, Polly Baker, Mark Cranley, Shreshth Dharm-Datta, Henrietta Ellis, Duncan Goodall, Michael Gough, Sarah Lewis, Jonathan Norman, Theodora Papadopoulou, David Roscoe, Daniel Sherwood, Philippa Turner, Tammy Walker, Alan Mistlin, Rhodri Phillip, Alastair M Nicol, Alexander N Bennett, Sardar Bahadur
Journal: British Journal of Sports Medicine (2020)

The highly infectious and pathogenic novel coronavirus (CoV), severe acute respiratory syndrome (SARS)-CoV-2, has emerged causing a global pandemic. Although COVID-19 predominantly affects the respiratory system, evidence indicates a multisystem disease which is frequently severe and often results in death. Long-term sequelae of COVID-19 are unknown, but evidence from previous CoV outbreaks demonstrates impaired pulmonary and physical function, reduced quality of life and emotional distress. Many COVID-19 survivors who require critical care may develop psychological, physical and cognitive impairments. There is a clear need for guidance on the rehabilitation of COVID-19 survivors. This consensus statement was developed by an expert panel in the fields of rehabilitation, sport and exercise medicine (SEM), rheumatology, psychiatry, general practice, psychology and specialist pain, working at the Defence Medical Rehabilitation Centre, Stanford Hall, UK. Seven teams appraised evidence for the following domains relating to COVID-19 rehabilitation requirements: pulmonary, cardiac, SEM, psychological, musculoskeletal, neurorehabilitation and general medical. A chair combined recommendations generated within teams. A writing committee prepared the consensus statement in accordance with the appraisal of guidelines research and evaluation criteria, grading all recommendations with levels of evidence. Authors scored their level of agreement with each recommendation on a scale of 0–10. Substantial agreement (range 7.5–10) was reached for 36 recommendations following a chaired agreement meeting that was attended by all authors. This consensus statement provides an overarching framework assimilating evidence and likely requirements of multidisciplinary rehabilitation post COVID-19 illness, for a target population of active individuals, including military personnel and athletes.
Prevalence and characterization of dermatologic adverse events related to alpelisib (BYL719) in breast cancer patients.
Authors: Dulce M. Barrios M.S, Diana G. Wang, Victoria Susana Blinder, Jacqueline Bromberg, Pamela Drullinsky, Samuel Aaron Funt, Komal L. Jhaveri, Diana Lake, Tomas Lyons, Shanu Modi, Pedram Razavi, Michelle Sidel, Tiffany A. Traina, Linda T. Vahdat, Mario E. Lacouture
Journal: Journal of Clinical Oncology (2020)

1063 Background: Rash develops in approximately 50% of breast cancer patients receiving alpelisib, often requiring dose modifications. Herein, we describe the characteristics of alpelisib-related dermatologic adverse events (dAEs). Methods: A single center retrospective analysis was conducted via review of electronic medical records. We collected clinical, laboratory and management data relevant to patients treated with alpelisib for advanced breast cancer under four different randomized clinical trials or post approval by regulatory agencies from 6/1/2013 to 7/31/2019. Type and severity of dAEs was recorded using the Common Terminology Criteria for Adverse Events version 5.0 (CTCAE v5.0). Results: A total of 102 patients (mean age 56 years, range 27-83) receiving alpelisib from 200 to 350 mg daily, most frequently in combination with endocrine therapy (79, 77.5%) were included. We identified 41 (40.2%) patients with all-grade rash [CTCAE grade 1/2 = 22 (21.6%); CTCAE grade 3 = 19, (18.6%)] distributed primarily along the trunk (18, 78%) and developing, on average, within 12.8 +/- 1.5 days of treatment initiation (n = 38). Mean duration of rash was 7.1 +/- 3.8 days; and no grade 4 dAEs were observed. Of 29 patients with documented morphology of alpelisib-related dAEs, the majority (26, 89.7%) had maculopapular rash. Thirteen (68%) of 19 patients with any-grade rash and report of any associated symptoms had pruritus (7, 36%) or burning pain (6, 32%). All-grade dAEs correlated with an increase in serum eosinophils from 2.7% to 4.4% (p &lt; 0.05), and prophylaxis with non-sedating antihistamines (n = 43) was correlated with a reduction of grade 1/2 rash onset (OR 0.39, p = 0.09). Sixteen (84.2%) of 19 patients with grade 3 dAEs had interruption of alpelisib, followed by management with antihistamines, topical and/or systemic corticosteroids. We did not observe rash recurrence in 12 (75%) of these 16 patients who re-initiated therapy; and the majority (9, 56.3%) were re-challenged without a dose reduction. Conclusions: Pruritus and increased blood eosinophils occur with maculopapular rash within the first two weeks of initiating alpelisib and persists for approximately seven days. To reduce onset of grade 1/2 rash, non-sedating antihistamines (i.e. cetirizine) are recommended during the first eight weeks. While grade 3 rash leads to interruption of alpelisib, dermatologic improvement is evident with systemic corticosteroids; and most patients can resume therapy at a maintained or reduced dose upon re-challenge.
Quality and reliability of online video information of breast cancer in Spanish.
Authors: Fernando Cristobal Diaz, Ismael Pavel Polo Perez, Dailis Barbara Corria Cedeno, Michael LaPelusa, Dave Patel, Hansapani Sarasepa Rodrigo
Journal: Journal of Clinical Oncology (2020)

11039 Background: Online health information is a central part of how patients learn about a cancer diagnosis. Involving patients in shared decision making is associated with better outcomes. Previous studies have identified a lack of high-quality, reliable online material related to cancer in English using validated tools. As the number of Spanish speaking people in the US, and globally, continues to grow, it is important that high-quality, reliable information is available in Spanish. No studies have evaluated online breast cancer informational videos in Spanish. Methods: A search using the phrase “cancer de mama” (translation: “breast cancer”) was conducted on YouTube. The first 200 video URLs were included for study with duplicates, non-Spanish, and non-informational videos excluded. The videos were characterized by several variables, including year of upload, country of origin, content discussed, views, likes, dislikes, and typology group (“Personal”, “Professional”, “Health Portal”, etc.). The quality and reliability of these videos were examined by measuring Global Quality Scale (GQS), a 5-point DISCERN score, and JAMA scores. Results: 173 videos met inclusion criteria in the study. The majority of the videos which discussed signs and symptoms were uploaded by a ‘commercial’ typology, risk factors mainly uploaded by ‘health portals’ (21%), and treatment options by ‘professionals’ (50%). Relatively few videos have discussed reconstruction, survivorship, and breast cancer in men. 57% of these videos were uploaded prior to 2017, 36% by different personnel followed by government/news agency (25%), and professionals (23%). There was no significant difference between number of views (p-value: 0.526) and likes (p-value: 0.122) among the five typology groups. Professional videos had the highest average GQS (2.55), DISCERN score (1.90), and JAMA score (2.05). Personal videos had the lowest average GQS (1.98) and DISCERN score (1.06). GQS, DISCERN, and JAMA scores were all statistically significantly different between each typology. Conclusions: The majority of online breast cancer videos in Spanish are older than 3 years and produced outside the US. They are generally of poor quality and reliability, although higher in professional videos. Given the lack of current, high-quality, and reliable informational videos available, needs assessments should be conducted to identify the most useful learning resources for Spanish-speaking patients. Specialists should consider uploading educational videos to improve the paucity of high-quality, reliable information online.
副肿瘤性小脑变性二例
Authors: 代秀芹
Journal: BMJ (2006)

副肿瘤性小脑变性(paraneoplastic cerebellar degen-eration,PCD)是一种与肿瘤相关,但原因不明的小脑非转移性病变,可能与抗肿瘤抗体和神经细胞之间的交叉反应有关[1].临床报告较少,现报告2例并复习相关文献。
Abstract 11745: Noninvasive Estimation of Left Ventricular End-diastolic Pressure Using Left Atrial Area Strain Obtained by Transthoracic 3D Speckle Tracking Echocardiography in Patients With Coronary Artery Disease
Authors: Tomoyuki Banno, Kazuaki Wakami, Shohei Kikuchi, Hiroshi Fujita, Toshihiko Goto, Hidekatsu Fukuta, Yoshihiro Seo, Nobuyuki Ohte
Journal: Circulation (2019)

An elevated left ventricular (LV) end-diastolic pressure (EDP) or an elevated left atrial (LA) pressure (P) relates LA wall deformation. Recently transthoracic 3D speckle tracking echocardiography ...
Automated identification of lymphoma involving the bone from PET/CT reports using natural language processing and adaptive learning.
Authors: Anastasia Navitski, Piyush Goyal, Salma Ahsanuddin, Serena Zheng, Erel Joffe
Journal: Journal of Clinical Oncology (2020)

e19201 Background: Automated extraction of key clinical features from imaging reports, such as the site, size and FDG avidity of lesions would allow for automatic determination of disease stage, response to treatment and relapse. Since the language used in clinical notes is domain and often task-specific, generic Natural Language Processing (NLP) tools are of limited utility. We describe a strategy for a rapid construction of task-specific NLP algorithms. As a test case, we aimed to identify bone involvement with lymphoma from PET/CT reports. Methods: We use an adaptive-learning approach to facilitate the generation of task-specific lexicons by a domain expert. In the case of identifying bone lymphoma, these include words describing the primary aspect (PA: e.g., “ uptake”, “SUV”); the secondary aspect, in this case, osseous sites (SA: e.g., “skeleton”, “T5”); modifiers such as context-specific affirmation/ negation/ uncertainty (e.g., “increased”/ “likely reactive”/ “possibly disease”) and generic negation (e.g., “no evidence of”). Presented with sentences containing seed PA terms, an expert is tasked with an exhaustive identification of terms for the other lexicons. In an iterative process, unseen sentences that do not include terms previously identified are presented for lexicon expansion. The process is repeated until no further expansion is possible. An explicit rule-based algorithm is built based on the lexicons to classify sentences as supporting, negating or inconclusive (i.e., requiring manual review) for the feature of interest. We used 500 reports to develop the algorithm, evaluated performance against 516 unseen reports that were independently classified by a blinded annotator, and measured the amount of effort (number of iterations) required to complete the PA and SA lexicon expansion. Results: Of 44 reports with bone involvement identified by the algorithm, 43 had an actual involvement and 1 was a negative case (PPV: 98%). Of 380 reports flagged as negative, 379 were truly negative and 1 was positive (NPV: 99.7%). Sensitivity was 64% (43/67); specificity 84% (379/449); 18% (93) reports were flagged for manual review. It took 13 and 5 iterations to build the PA and SA lexicons, each involving the review of up to 10 sentences. Conclusions: With minimal effort, we were able to construct a high-accuracy NLP system specific for identifying bone lymphoma. This approach can be extended to other contexts (e.g., lung involvement), domains (e.g., pathology reports), or to be utilized in machine learning.