tbuckley/cabot-search huggingface dataset:
Predictive scoring systems for distant metastases in oral cavity squamous cell carcinoma.
Authors: Hsueh Ju LU, Kuan-Ming Lai, Chih-Yu Peng, Hsien-Chun Tseng, Chung-Han Hsin, Wei-Shiou Huang, Wen-San Lan, Sung-Fa Yang
Journal: Journal of Clinical Oncology (2020)

e18536 Background: At least 10% of patients with oral cavity squamous cell carcinoma (OCSCC) would progress to distant metastases (DM). Median overall survival (OS) after distant metastases is only one year and rare biomarkers are available to predict distant metastatic events. Methods: A total of 595 OCSCC patients who underwent curative surgical resection at Chung Shan Medical University Hospital were enrolled from Jan 2010 to Dec 2016. The clinical–pathological variables were compared using the χ 2 test. Cox proportional-hazards analyses were performed for distant metastatic free survival (DMFS), defined from the date of initial diagnosis to the date of distant metastasis. Two scoring systems for predicting distant metastases were established for patients with pathologic regional lymph node –positive (pN+) or –negative (pN–), separately. Results: Nearly 10% (8.9%, 53/595) of patients with OCSCC would progress to DM during follow-up [20.6% (28/136) and 5.4% (25/459) for patients with pN+ and pN–, respectively]. Most of the distant metastatic lesions developed within 3 years after initial diagnosis (overall, 84.9%, 45/53; patients with pN+, 92.9%, 26/28; patients with pN–, 76.0%, 19/25). For patients with pN+, rapidly locoregional recurrence (≦6 months), lymphovascular invasion, and lymphocyte-monocyte ratio(&lt;2.5) were the independent factors for DMFS. In addition, rapidly locoregional recurrence, elderly (age &gt; 65), and close surgical margin(≦5mm) were independent for those with pN–. If each of the independent factors was scored one point to predict DM occurring within 3 years after the initial diagnosis, two scoring systems were established for the corresponding patients with pN+ or pN–, separately. The area under the curves of these two scoring systems for the corresponding patients with pN+ and pN– were 0.737 and 0.825, respectively (Table). Conclusions: The established scoring systems effectively predict distant metastases for OCSCC patients. [Table: see text]
Initial analyses of a phase I/II trial of durvalumab (D) plus tremelimumab (T) and stereotactic body radiotherapy (SBRT) for oligometastatic head and neck carcinoma.
Authors: Houda Bahig, Francine Aubin, Phuc Felix Nguyen-Tan, Denis Souliere, David A. Palma, Danielle Charpentier, Brock J Debenham, Rahima Jamal, Khalil Sultanem, Olivier Ballivy, Edith Filion, Philip Wong
Journal: Journal of Clinical Oncology (2020)

6531 Background: PD-1/PD-L1 +/- CTLA-4 blockade in head-and-neck carcinoma (HNSCC) has shown signs of clinical activity. SBRT aims to reduce tumor burden and perhaps be immune-stimulatory. This analysis seeks to assess the safety and efficacy signal of the triple treatment combination (TTC) consisting of SBRT sandwiched between cycles of D (αPD-L1) and T (αCTLA-4) in oligometastatic (2-10) HNSCC. Methods: This is a single arm multi-institutional phase I/II trial (NCT03283605). D (1500 mg) and T (75 mg) were given for 4 monthly cycles, followed by monthly D. SBRT to 2-5 lesions was administered during cycle 2. The median prescribed and maximum SBRT doses were 40 Gy (range:18-50) and 49 Gy (range:28-61), respectively, given in 3-5 fractions. Global health status was derived from EORTC QLQ C30 questionnaires. Results: At data cut-off (Dec 31, 2019), 20 patients were recruited, of which 16 had a study treatment and were analyzed. Table describes the patient characteristics. There were 1 CTCAE V5.0 Grade 2 and 1 Grade 3 (both GI) serious adverse event (SAE) attributable to D and T. Two patients had unrelated SAEs (1 Grade 3-hypercalcemia and 1 Grade 5-GI). The Grade 5 SAE was a gastric hemorrhage that occurred the night of the first D + T infusion. There was no Grade 3+ AE secondary to SBRT. Thus, SBRT did not add to the 2/16 patients who had D + T related SAEs. Global health status scores did not differ statistically between baseline (75) and cycle 3 (73). Of the 14 patients that received SBRT, 7 patients had RECIST target lesions untreated by SBRT. The best responses for these 7 patients were: 1 CR, 3 PR, and 3 SD. When SBRT treated lesions are included and analyzed per RECIST (n = 14), there were 9 PR, 3 SD and 2 PD. The estimated median progression free survival was 7.2 months. Conclusions: The first 16 evaluable patients demonstrated tolerable profiles to the TTC (D + T + SBRT) for the treatment of oligometastatic (≤10 lesions) HNSCC. Best response rates were encouraging and could be due to the addition of SBRT during immunotherapy that served to either stimulate the immune system or annihilate slow responding or immunotherapy resistant lesions. Smaller overall tumor burden and 7/16 patients being treated in first line could also have contributed to better results. Clinical trial information: NCT03283605 . [Table: see text]
Thinking through prior bodies: autonomic uncertainty and interoceptive self-inference
Authors: Micah Allen, Nicolas Legrand, Camile Maria Costa Correa, Francesca Fardo
Journal: Behavioral and Brain Sciences (2020)

The Bayesian brain hypothesis, as formalized by the free-energy principle, is ascendant in cognitive science. But, how does the Bayesian brain obtain prior beliefs? Veissière and colleagues argue that sociocultural interaction is one important source. We offer a complementary model in which "interoceptive self-inference" guides the estimation of expected uncertainty both in ourselves and in our social conspecifics.
血浆葡萄糖异常的临床解读
Authors: 冯微
Journal: BMJ (2008)

糖的重要生理功能是氧化供能,同时也是人体的重要组成成分和机体的重要碳源.人体进食的糖类经过消化道内酶的作用,变成小分子的单糖(主要是葡萄糖)被肠道吸收入血,一部分变为肝糖原储存于肝脏,其余的进人体循环被运输到全身各组织加以利用和储存。
Racial and socioeconomic disparities in the treatment of resectable hepatocellular carcinoma.
Authors: Young soo Rho, Ian Pagano, Jared David Acoba
Journal: Journal of Clinical Oncology (2020)

e19026 Background: Cancer surgeries performed at high case volume centers (hCVCs) are associated with improved surgical and clinical outcomes. Resectable hepatocellular carcinoma (rHCC) is not common in the US and the impact of surgery at hCVCs has not been well assessed. We analyzed the impact of surgery at hCVCs on survival, and the potential racial and socioeconomic disparities associated with obtaining care at hCVCs. Methods: We collected demographic, diagnostic, treatment, and survival data of 96,215 patients with stage I-III HCC diagnosed between 2004 – 2015 from the National Cancer Database. To estimate the average surgical volume/year, number of reported cases were divided by the number of years the facility was represented in the database. Logistic regression was used to determine the associations between case volume, facility type and the demographic and clinical variables. We assessed demographic and clinical predictors of overall survival (OS) using Cox proportional hazards regression. Results: In total, 10,419 resected HCC patients were included in the analysis. The median age was 64 (18 – 90), 68.4% were male and 69.5% were white. Facilities were divided into quartiles by average number of surgical CV/year: 1st quartile (1Q) 0.08-1.60, 2Q 1.61 – 3.91, 3Q 3.92 – 8.34, and 4Q 8.35 – 45.34. In a multivariate model, improved OS was seen with each increase in quartiles with the highest CVCs (i.e 4Q) HR 0.70 (95% CI 0.63 – 0.77). Treatment at academic centers did not show an OS advantage (HR 0.93; 95% CI 0.86 – 1.01). Factors including black race (OR 0.83; 95% CI 0.75-0.93), age 65+ (OR 0.91; 95% CI 0.82 – 1.00), and living in a metro area with a population of 250,000 – 1 million people (OR 0.68; 95% CI 0.62 – 0.74) were less likely to be associated with treatment at hCVCs. Conversely, Asians/Pacific Islanders (OR 2.28; 95% CI 2.04 – 2.55) and those with private insurance (OR 1.33; 95% CI 1.18– 1.40) or Medicare (OR 1.21; 95% CI 1.05 – 1.38) were more likely to be treated at hCVCs. Conclusions: rHCC is not common in the US and having surgery at hCVCs improves OS. However, racial and socioeconomic disparities exist in receiving care at these hCVCs.
梗阻性黄疸的影像学诊断
Authors: 曾祥柱, 谢敬霞
Journal: BMJ (2012)

胆道梗阻常见病因主要有胆道结石、炎症和胆系肿瘤.影像学检查巾,超声、CT、MRI可明确梗阻的部位、性质及梗阻程度；经皮肝穿刺胆管造影(WC)及内镜下逆行胰胆管造影术(ERCP)为有创伤性检查,目前主要用于梗阻性黄疸的介入治疗。
Survey on Introduction to General Practice course taking and knowledge of General Practice among medical students in Fudan University
Authors: Jian Wang, Qi Zhao, Shanzhu Zhu, Zhigang Pan
Journal: BMJ (2018)

Objective
To survey Introduction to General Practice course taking and knowledge of general practice among medical students in Fudan University.


Methods
A survey with self-designed questionnaire was conducted in June 2017 among medical students of 5 year program in Fudan University who had taken  course of Introduction to General Practice.


Results
One hundred and ninety seven questionnaires were distributed and 186 valid ones returned with a recovery rate of 94.42%. The survey showed that 95.16% of participants (177/186) gained knowledge about  post of general practitioners (GPs) through community practice; 97.31% (181/186) thought community practice as necessary; 92.47% (172/186) were very satisfied or fairly satisfied with  community practice course; 94.09% (175/186) gained clear understanding of  duty of GPs through  course study; 87.63% (163/186) completely understood  required capabilities of a GP; 74.19% (138/186) said that  course had opened their mind; 64.52% (120/186) said that they had changed their views about general practice; 63.44% (118/186) said that they had acquired new knowledge. The participants also gave some suggestions regarding  content of community practice. Although 96.24% of  students (179/186) thought that general practitioner had a bright career prospect, only 7 of them (3.76%) were willing to be GPs after graduation; meanwhile 161 of them (86.56%) were willing to be specialists. The main reasons of  willing to be a GP were wish to be a specialists (82.61%,133/186) , the job was  challenging or difficult for career development (45.34%,  and not paid well for GPs (45.34%, 73/186) .


Conclusion
Although many students thought GP would have good career prospect, only few of them are willing to be a GP. How to attract more medical students to chose GP as their career should be paid high attention by education and health authorities.


Key words: 
General practice; Education; Medical students
Do herbal drinks augment the cytotoxic effect against different cancer cells? Are they potent stimulators of innate and acquired immunity?
Authors: Israa Adnan, Wamidh Talib
Journal: Journal of Clinical Oncology (2020)

e21657 Background: The herbal drinks are highly prevalent in the Middle East and are consumed in large quantities as daily drinks. Few studies have evaluated the biological activities of the herbal drinks produced from some plants.The current study aims to evaluate the anticancer and immunomodulatory activities of five herbal drinks consumed in the Middle East. These drinks are Palestinian Zhourat, Lebanese Zhourat, Lemon and Ginger combination, Wild Thyme, and Marjoram. Methods: The selected herbal drinks as concentrated water extracts were tested separately for: A. Anti-cancer effect on the cell lines (MCF-7, MDA-MB231, HCT-116, A549, and Vero-normal cells) by assessing: - Antiproliferation activities using MTT assay. Apoptosis (using the caspase-3 assay) and vascular endothelial growth factor (VEGF) expression (using ELISA kit) for the most potent antiproliferative extract. B. Immunomodulatory effect by evaluating: - Splenocytes proliferation using the mitogen proliferation assay. Phagocytosis activity using the nitro blue tetrazolium assay. - Pinocytosis function using the neutral red method. Results: The Lemon and Ginger combination was the most potent against MDA-MB231, MCF-7 and A549l cell lines with IC50 3.5,4, 6.5mg/ml, respectively. Lemon and Ginger combination and Wild thyme separately showed high apoptosis induction and angiogenesis suppression on the MDA-MB231cell line at concentrations 3.5 and 4.4 mg/ml for both extracts, respectively. Wild thyme was the most potent stimulant lymphocyte proliferation (with index 4.7), and Marjoram has the highest percentage (314.4%) in phagocytosis activity, while moderate stimulation by Zhourat was noted. Lemon and Ginger combination, Wild thyme, Marjoram, and the Lebanese herbal drink "Zhourat" were the most active extracts in stimulating pinocytosis with absorbance value 0.5745,0.4645,0.461,0.4575 nm, respectively. Meanwhile, the Palestinian herbal drink "Zhourat" had a moderate effect. Conclusions: The consumption ofthe mentioned herbal drinks has various Anti-cancer and immunomodulatory effects. Lemon and ginger combination exhibits the most potent anticancer activities. Wild thyme and marjoram are potent stimulators of innate and acquired immunity. The result achieved in this study is very optimistic and encouraging to be considered for further clinical trials.
糖尿病合并贫血患者糖化血红蛋白结果分析一例
Authors: 肖国辉, 张铭
Journal: BMJ (2008)

患者女,43岁.2型糖尿病史3年,因近2月余血糖控制不佳,于2007年3月10日来我院就诊,检测空腹血糖9.8mmol/L,糖化血红蛋白(HbA1c)4.O％(正常参考值4.2％～6.2％).患者自述平时用快速血糖仪检测空腹血糖,其值多在7.8～10.2 mmol/L之间,因HbA1c检测结果与患者血糖水平相矛盾,对患者进一步检查.患者面色苍白,呈贫血貌,乏力、心悸、食欲不振,伴月经过多,并有胃溃疡。
Evaluation of comprehensive cardio-pulmonary resuscitation training in non-medical undergraduates
Authors: Liyun Wang, Lizheng Fang, Wenhua Zhu
Journal: BMJ (2017)

Total 280 non-medical undergraduates (174 males and 106 females) were enrolled in the study from September 2015 to January 2016. Among all participants, 132 received comprehensive cardio-pulmonary resuscitation (CPR) training, including knowledge teaching, video playing and simulation practice (study group), and 148 received knowledge teaching and simulation practice only (control group). Changes of CPR knowledge, skills and willingness were evaluated before and after training, and compared between two groups. The theory scores were increased after the training in both groups (study group: 87.7±5.6 vs. 47.9±4.7, P 0.05), however, there was significant difference after the training (P 0.05), however, there was significant difference after the training (P 0.05), however, there was significantly difference after the training (P<0.01). The study shows that comprehensive training can enhance CPR knowledge, skills and willingness for non-medical undergraduates, indicating that it may also be effective for other social groups.


Key words: 
Cardiopulmonary resuscitation; Health education; Students, universities
The Major Pre- and Postmenopausal Estrogens Play Opposing Roles in Obesity-Driven Mammary Inflammation and Breast Cancer Development
Authors: Rehana Qureshi, Manuel Picon-Ruiz, Iskander Aurrekoetxea-Rodriguez, Vanessa Nunes de Paiva, Massimo D’Amico, Hyunho Yoon, Ramya Radhakrishnan, Cynthia Morata-Tarifa, Tan Ince, Marc E. Lippman, Seth R. Thaller, Steven E. Rodgers, Susan Kesmodel, Maria del Mar Vivanco, Joyce M. Slingerland
Journal: Cell Metabolism (2020)
Diagnostic value of different imaging methods for cholangiocarcinoma
Authors: Xiaocheng Liu, Chengbo Li, Linlin Yan, Hao Jiang
Journal: BMJ (2016)

Cholangiocarcinoma is a malignant tumor that occurs in the bile duct epithelium, it is the second most common malignant tumor of the liver and bile duct after hepatocellular carcinoma. Imaging examination is an important method to detect bile duct cancer; the purpose of imaging is to determine the location of the tumor, and the extent of invasion and distant metastasis. Different imaging methods have their advantages and disadvantages, so they should be chosen based on the condition of patients, or be optimized as the combined detection.


Key words: 
Cholangiocarcinoma; Diagnostic imaging; Radiography, abdominal
Evaluation of the constructed device along with the software for digital archiving, sending the data, and supporting the diagnosis of cervical cancer.
Authors: Jacek Gronwald, Lukasz Lasyk, Jakub Barbasz, Pawel Zuk, Artur Prusaczyk, Tomasz Włodarczyk, Ewa Prokurat, Wlodzimierz Tadeusz Olszewski, Mariusz Bidziński
Journal: Journal of Clinical Oncology (2020)

e18017 Background: The incidence and mortality of cervical cancer are high in Poland. There are effective methods of the prevention and the early diagnosis, however they require well-trained medical professionals including cytologists. Within this project we built a prototype of a new device together with implemented software to convert the currently used optical microscopes to fully independent scanning systems for cytological samples. The use of the device is intended to improve the effectiveness of cytological screening, and registration of cytological tests’ results. The features of the software include digital backup as well as transmission and telemedicine evaluation. Methods: The software uses the artificial neural network (U-NET architecture) designed to be able to recognize suspicious regions and enhanced CNN neural network (VGG) allowing to determine the type of disorder such as: ASCUS, ASC-H, HIS, AGC, cancer. 7128 liquid based (LBC) and 1700 conventional cytology samples were evaluated by trained cyto-sreeners. Cytological abnormalities like: ASCUS, ASC-H, HIS, AGC, cancer were found in 254 (3.6%) LBC cases and 51 (3.0%) conventional cytology cases. All samples were scanned and archived. Selected samples with diagnosed abnormality were a model to teach the artificial neural networks. Results: Preliminary results obtained with use of U-NET and VGG (CNN networks) so far indicate 90-96% (LBC samples) and 85-95% (conventional cytology) compliance with results obtained using standard methods. Conclusions: Further refinement of neural networks is necessary to reduce the number of false positives and false negatives. A study with a larger sample size is required to evaluate the software. This project is co-financed with European Regional Development Fund within the Priority Axis I, Support for R&amp;D activities for companies, Measure 1.2, Sectoral R&amp;D Programmes, Sectoral Programme: “INNOMED – scientific research and development programme for innovative medicine economy sector”.
A novel prediction model to identify patients with early-stage pancreatic cancer.
Authors: Daniel R Cherry, Qinyu Chen, James Don Murphy
Journal: Journal of Clinical Oncology (2020)

e16801 Background: Pancreatic cancer has an insidious presentation with four-in-five patients presenting with disease not amenable to potentially curative surgery. Efforts to screen patients for pancreatic cancer using population-wide strategies have proven ineffective. We applied a machine learning approach to create an early prediction model drawing on the content of patients’ electronic health records (EHRs). Methods: We used patient data from OptumLabs which included de-identified data extracted from patient EHRs collected between 2009 and 2017. We identified patients diagnosed with pancreatic cancer at age 40 or later, which we categorized into early-stage pancreatic cancer (ESPC; n = 3,322) and late-stage pancreatic cancer (LSPC; n = 25,908) groups. ESPC cases were matched to non-pancreatic cancer controls in a ratio of 1:16 based on diagnosis year and geographic division, and the cohort was divided into training (70%) and test (30%) sets. The prediction model was built using an eXtreme Gradient Boosting machine learning algorithm of ESPC patients’ EHRs in the year preceding diagnosis, with features including patient demographics, procedure and clinical diagnosis codes, clinical notes and medications. Model discrimination was assessed with sensitivity, specificity, positive predictive value (PPV) and area under the curve (AUC) with a score of 1.0 indicating perfect prediction. Results: The final AUC in the test set was 0.841, and the model included 583 features, of which 248 (42.5%) were physician note elements, 146 (25.0%) were procedure codes, 91 (15.6%) were diagnosis codes, 89 (15.3%) were medications and 9 (1.54%) were demographic features. The most important features were history of pancreatic disorders (not diabetes or cancer), age, income, biliary tract disease, education level, obstructive jaundice and abdominal pain. We evaluated model performance at varying classification thresholds. When applied to patients over 40 choosing a threshold with a sensitivity of 20% produced a specificity of 99.9% and a PPV of 2.5%. The model PPV increased with age; for patients over 80, PPV was 8.0%. LSPC patients identified by the model would have been detected a median of 4 months before their actual diagnosis, with a quarter of these patients identified at least 14 months earlier. Conclusions: Using EHR data to identify early-stage pancreatic cancer patients shows promise. While widespread use of this approach on an unselected population would produce high rates of false positives, this technique could be employed among high risk patients, or paired with other screening tools.
Use of Twitter among cancer clinicians and researchers and the associations with scientific impact of its users and followers.
Authors: Winson Y. Cheung, Rodrigo Rigo, Atul Batra
Journal: Journal of Clinical Oncology (2020)

e14101 Background: Social media channels, such as Twitter, represent relatively new technology platforms for scientific users to disseminate research findings and communicate their views and interpretations to colleagues and followers. To date, the associations between the use of Twitter and the scientific impact of its users and followers are unclear. Methods: All Canadian oncologists who are full members of the American Society of Clinical Oncology were identified from the online membership directory. Users of Twitter were defined as those with an active Twitter account, as of June 2019, and posted at least one tweet within the past 12 months. Data regarding the number of tweets, likes, and followers were collected by an online search of Twitter. Scientific impact of each individual was assessed based on a user’s h-index and number of citations from Google Scholar as well as score from Research Gate. Associations were examined with summary statistics and correlation coefficients. Results: We identified 676 eligible oncologists of whom 80 (12%) and 596 (88%) currently use and do not use Twitter. Among the users, the median number (IQR) of tweets, likes, and followers were 196 (45-865), 325 (86-1,246), and 198 (89-449), respectively. The scientific impact of Twitter users versus non-users was statistically similar (see Table). Likewise, within the group of users, there were no correlations between the number of tweets, likes, and followers and the scientific impact of individuals (correlation coefficients 0.38, 0.34, and 0.41, respectively, all p &gt; 0.05). Conclusions: Only 1 in 10 oncologists use Twitter, but those who use Twitter leveraged this technology platform frequently. There were no associations between the use of Twitter and the scientific impact of its users. Views from a minority of oncologists are represented on Twitter. Such potential bias may underscore the potential need to exercise caution when using social media for scientific knowledge exchange. Regular evaluations of new technologies are warranted to ensure the quality and rigor of their scientific content in order to reduce misrepresentation. [Table: see text]