tbuckley/cabot-search huggingface dataset:
Fifteen year quality of life outcomes in men with localised prostate cancer: population based Australian prospective study
Authors: Carolyn G Mazariego, Sam Egger, Madeleine T King, Ilona Juraskova, Henry Woo, Martin Berry, Bruce K Armstrong, David P Smith
Journal: BMJ (2020)

Abstract Objective To assess treatment related changes in quality of life up to 15 years after diagnosis of localised prostate cancer. Design Population based, prospective cohort study with follow-up over 15 years. Setting New South Wales, Australia. Participants 1642 men with localised prostate cancer, aged less than 70, and 786 controls randomly recruited from the New South Wales electoral roll into the New South Wales Prostate Cancer Care and Outcomes Study (PCOS). Main outcome measures General health and disease specific quality of life were self-reported at seven time points over a 15 year period, using the 12-item Short Form Health Survey scale, University of California, Los Angeles prostate cancer index, and expanded prostate cancer index composite short form (EPIC-26). Adjusted mean differences were calculated with controls as the comparison group. Clinical significance of adjusted mean differences was assessed by the minimally important difference, defined as one third of the standard deviation (SD) from the baseline score. Results At 15 years, all treatment groups reported high levels of erectile dysfunction, depending on treatment (62.3% (active surveillance/watchful waiting, n=33/53) to 83.0% (non-nerve sparing radical prostatectomy, n=117/141)) compared with controls (42.7% (n=44/103)). Men who had external beam radiation therapy or high dose rate brachytherapy or androgen deprivation therapy as primary treatment reported more bowel problems. Self-reported urinary incontinence was particularly prevalent and persistent for men who underwent surgery, and an increase in urinary bother was reported in the group receiving androgen deprivation therapy from 10 to 15 years (year 10: adjusted mean difference −5.3, 95% confidence interval −10.8 to 0.2; year 15: −15.9; −25.1 to −6.7). Conclusions Patients receiving initial active treatment for localised prostate cancer had generally worse long term self-reported quality of life than men without a diagnosis of prostate cancer. Men treated with radical prostatectomy faired especially badly, particularly in relation to long term sexual outcomes. Clinicians and patients should consider these long term quality of life outcomes when making treatment decisions.
Circular RNAs in cancer: Limitations in functional studies and diagnostic potential
Authors: Feiya Li, Qiwei Yang, Alina T. He, Burton B. Yang
Journal: Seminars in Cancer Biology (2020)

Circular RNAs (circRNAs) are a large class of noncoding RNAs, generated from a process called back-splicing, that possess critical regulatory functions in many cellular events. A large body of literature has reported various circRNA functions and their underlying mechanisms, including sponging miRNA, exerting transcriptional and translational regulation, interacting with proteins, and translating into peptides and proteins. CircRNA dysregulation has been implicated in many cancers, including lung, breast, liver, gastric, colorectal, and ovarian cancer. They are detectable in bodily fluids and relatively stable, making them potential cancer biomarker candidates. Furthermore, targeting circRNA expression levels is a potential therapeutic approach for treating cancers. In this review, we describe the functional mechanisms of circRNAs and discuss limitations of current mechanism studies. Following this, we outline the potential of circRNAs to be effective biomarkers in various cancers and present circRNA-based therapeutic approaches. Finally, we discuss challenges in using circRNAs as diagnostic and therapeutic tools and propose future research directions.
Malleable Hydrogels: Malleable Hydrogel Embedded with Micellar Cargo‐Expellers as a Prompt Transdermal Patch (Adv. Healthcare Mater. 19/2020)
Authors: Sung‐Ho Shin, Youngho Eom, Eun Seong Lee, Sung Yeon Hwang, Dongyeop X. Oh, Jeyoung Park
Journal: Advanced Healthcare Materials (2020)

In article number 2000876, Sung Yeon Hwang, Dongyeop X. Oh, Jeyoung Park, and co-workers fabricate a malleable and rapid-cargo-releasing poly(vinyl alcohol)-borax hydrogel that embeds freely mobile poly(hydroxyethyl methacrylate) micelles. Upon exposure to wet conditions, the micelle particles escaping from the hydrogel act as a “conveyor belt” to effectively expel the cargo into the external environment.
The association between Medicaid insurance, biomarker testing, and outcomes in patients with advanced non-small cell lung cancer (aNSCLC).
Authors: Cary Philip Gross, Craig S. Meyer, Sarika Ogale, Matthew Kent, William Bruce Wong
Journal: Journal of Clinical Oncology (2020)

89 Background: Prior work suggests that patients (pts) with Medicaid experience lower quality cancer care and worse outcomes than pts with private insurance. It is unclear whether these disparities persist in the era of personalized medicine. We therefore examined the relation between Medicaid (vs private) insurance and receipt of biomarker testing, targeted therapy, and overall survival in a contemporary cohort of pts with aNSCLC. Methods: We conducted a retrospective study of pts with aNSCLC, diagnosed Jan 2011 through Sep 2019 using the nationwide US Flatiron Health EHR-derived de-identified databases comprising data from over 280 (largely community based) cancer clinics (~800 sites of care) and representing more than 2.4 million US cancer patients available for analysis. Eligible pts were 18-64 years old, had either Medicaid or Commercial insurance at the time of advanced diagnosis, and had a visit ≤120 days after advanced diagnosis. We assessed evidence of receipt of biomarker testing (ALK, EGFR, BRAF, ROS1, PDL1) according to year of diagnosis. The likelihood of testing, biomarker-driven therapy (immunotherapy (CIT) or tyrosine kinase inhibitor (TKI) treatment and mortality were compared by insurance type using Cox regression adjusted for baseline characteristics. Results: The sample included 6,145 commercially insured and 865 Medicaid pts. Compared with commercially insured pts, Medicaid beneficiaries were more likely to be Black (20% vs. 9.3%); P &lt; 0.01) and less likely to have evidence of testing with any biomarkers (57% vs. 71%; P &lt; 0.01). In the adjusted analysis, Medicaid pts were less likely to have evidence of testing (HR [95%CI]: 0.81 [0.74, 0.89], p &lt; 0.01), any 1L treatment (HR [95%CI]: 0.72 [0.66, 0.79], p &lt; 0.01) and 1L biomarker-driven therapy (HR [95%CI]: 0.70 [0.58, 0.84], p &lt; 0.01). A higher risk of death was observed in Medicaid vs. commercially insured pts (HR [95%CI]: 1.23 [1.13, 1.34], p &lt; 0.01) which was partially ameliorated after adjusting for testing and treatment (HR [95% CI: 1.15 [1.05, 1.25], p &lt; 0.01). Among Medicaid pts, those who had no biomarker tests had a 27% higher risk of mortality compared to those who had at least one test (HR [95% CI: 1.27 [1.06, 1.53], p &lt; 0.01). Conclusions: Medicaid pts with aNSCLC had a 23% higher risk of mortality than commercially insured pts. The increased risk of mortality was partially mediated by disparities in testing and treatment, and improved access to these resources may improve outcomes for Medicaid beneficiaries.
Dressing Up: The Journal of the American Medical Association
Authors: Erica J. M. D. Harris
Journal: JAMA (2020)

In this narrative medicine essay, an emergency department physician faces her daily dread of donning PPE during the COVID-19 pandemic by recalling her grandfather’s gear when diving into Idaho mine shafts and compares his heroism fighting for miners’ rights to safety and wonders what he would think of calling health care workers on the frontlines heroes
Editorial comment on discussion: ‘Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis’
Authors: Karim M Khan
Journal: British Journal of Sports Medicine (2020)

The BJSM recently published1 a network meta-analysis (NMA) on the effect of different modes of exercise training in patients with chronic non-specific low back pain.

The emergence of NMA in sport and exercise medicine2 represents important strides towards a ‘shift in what constitutes the highest level of medical evidence’.3 Given the novelty of NMA, frank scientific debate about strengths and limitations is a good thing. A discussion article by Maher and colleagues posed questions about the published NMA.4 As part of our due diligence at BJSM, we posted an Expression of Concern5 on the basis of the Maher et al ’s comments—we flagged that there were questions and we wanted time to consider those questions. An Expression of Concern merely flags to readers that the journal is taking a query seriously. The authors of the NMA addressed all of Maher’s points6 and BJSM recently broadcast the findings of the NMA with an Infographic.7 We also posted a podcast about the NMA and related research https://soundcloud.com/bmjpodcasts/what-are-the-best-exercises-to-manage-low-back-pain-with-aprof-daniel-belavy-episode-443?in=bmjpodcasts/sets/bjsm-1 …
Correction to: The Boldt scandal still in need of action: the example of colloids 10 years after initial suspicion of fraud
Authors: Christian J. Wiedermann, Michael Joannidis
Journal: Intensive Care Medicine (2020)

The article "The Boldt scandal still in need of action: the example of colloids 10 years after initial suspicion of fraud", written by Christian J. Wiedermann and Michael Joannidis, was originally published Online First without Open Access.
Pandemic preparedness: Government must release 2016 report, says information commissioner
Authors: Gareth Iacobucci
Journal: BMJ (2020)

The Information Commissioner’s Office has ordered the government to release an unpublished report on Exercise Cygnus, a 2016 exercise to test the UK’s preparedness for a flu pandemic.

Six months ago the NHS doctor Moosa Qureshi submitted a request under freedom of information legislation to the Department of Health and Social Care for England requesting the release of a report into Exercise Cygnus and threatening legal action if the health and social care secretary, Matt Hancock, failed to release the report.1

The Information Commissioner’s Office has now intervened, ordering the department to either release the information or explain its decision for withholding it within 20 days.

In mid-September …
Covid-19: Anaesthesia procedures may generate fewer aerosols than presumed, study suggests
Authors: Elisabeth Mahase
Journal: BMJ (2020)

Covid-19: Anaesthesia procedures may generate fewer aerosols than presumed, study suggests Elisabeth MahaseAnaesthesia procedures such as intubation and extubation during surgery may produce less aerosols than previously thought, according to a small study which is calling for a reappraisal of what constitutes an aerosol generating procedure (AGP) and the associated precautions for routine anaesthetic airway management.
Living with the COVID-19 pandemic: act now with the tools we have
Authors: Juliet Bedford, Delia Enria, Johan Giesecke, David L Heymann, Chikwe Ihekweazu, Gary Kobinger, H Clifford Lane, Ziad A Memish, Myoung-don Oh, Amadou Alpha Sall, Kumnuan Ungchusak, Lothar H Wieler
Journal: The Lancet (2020)
AB0896 EFFECTIVENESS OF SACROPLASTY IN THE MANAGEMENT OF OSTEOPOROTIC SACRAL FRACTURE IN ELDERLY PATIENTS
Authors: S. Hecquet, F. Verhoeven, S. Aubry, C. Prati, D. Wendling
Journal: Annals of the Rheumatic Diseases (2020)

Background: Sacral fractures are a source of pain leading to loss of autonomy in elderly patients. Sacroplasty may be an effective alternative of conservative medical treatment. Objectives: To evaluate the short-term analgesic effect of sacroplasty compared to conservative treatment in patients with osteoporotic sacral fractures Methods: This is a retrospective study of cases of osteoporotic sacral fractures treated with sacroplasty, compared with cases treated with conservative medical procedure over the same period. Outcome was evaluated by pain (Visual analogic scale) short-term (one month) evolution and side effects occurrence. Results: From January 2009 to June 2019, eleven patients were treated with sacroplasty for osteoporotic fractures at the Besançon University Hospital Centre. These were compared to 12 patients with osteoporotic sacral fracture with exclusive medical management, as a control group. The two groups were similar in age, gender and pain level at baseline. The median VAS was 7/10 in both groups at baseline, In the sacroplasty group, a significant decrease of pain was observed over the two first weeks, with a tendency remaining at day 30. There were no significant differences in the conservative treatment group at one week (p=0.2), fourteen days (p=0.6) and thirty days (p=0.7) compared to basal assessment. When comparing the sacroplasty group and the conservative treatment group, no differences were noted at baseline between the two groups, there was a significant difference between the two groups the following day (p=0.001), one week (p=0.003) and day 15 (p=0.01) after the intervention. However, there was no significant difference between the two groups at day 30, but only a trend (p=0.08). Regarding analgesic treatments, 30% of patients in the sacroplasty group could reduce their analgesics between the time they entered and left hospital. None of the patients in the control group were able to reduce their analgesic treatment over this period. In addition, half of the patients in the sacroplasty group were successful in returning home compared to only one-third of the patients in the conservative treatment group. Conclusion: In this study, sacroplasty was associated with an early and significant pain relief compared to conservative management in patients with osteoporotic sacral fracture. The procedure is well tolerated and may prevent loss of autonomy in these patients. Disclosure of Interests: None declared
Accuracy of SIE/SIES/GITMO Consensus Criteria for Unfitness to Predict Early Mortality After Intensive Chemotherapy in Adults With AML or Other High-Grade Myeloid Neoplasm
Authors: Raffaele Palmieri, Megan Othus, Anna B. Halpern, Mary-Elizabeth M. Percival, Colin D. Godwin, Pamela S. Becker, Roland B. Walter
Journal: Journal of Clinical Oncology (2020)

With increasing therapeutic alternatives available, there is growing interest in tools that accurately identify patients most suitable for intensive acute myeloid leukemia (AML) chemotherapy. Nowadays, conceptual criteria proposed by an Italian panel of experts are widely used for this purpose. How accurately these Ferrara criteria predict fitness for intensive chemotherapy is unknown.We assessed the fitness of adults undergoing intensive AML therapy based on Ferrara criteria and determined the accuracy of this assessment for early mortality and survival prediction.Among 655 adults who received curative-intent induction or reinduction chemotherapy with 7 days of standard-dose cytarabine and 3 days of an anthracycline ("7+3") CLAG-M (cladribine, high-dose cytarabine, granulocyte colony-stimulating factor, and mitoxantrone), or reduced-dose CLAG-M, 197 (30%) met at least one of the criteria defining unfitness for intensive chemotherapy (F-unfit). Compared with F-fit patients, the overall survival of F-unfit patients was significantly shorter (median, 4.8 months; 95% CI, 3.6 to 6.5 months v 36.8 months; 95% CI, 27.4 to 73.0 months; P < .001). When used alone, the Ferrara unfitness assessment was more accurate in predicting day 28 and day 100 mortality than the treatment-related mortality score we developed previously (used binary, ≤ 13.1 v > 13.1), as indicated by area under the receiver operating characteristic curve (AUC) values of 0.76 and 0.79 versus 0.66 and 0.62. The predictive accuracy of the Ferrara unfitness assessment could be significantly improved by including additional covariates such as performance status and albumin, yielding AUCs as high as 0.84-0.85 for the prediction of day 28 or day 100 mortality. Prediction of overall survival was less accurate, yielding a c-statistic value as high as 0.75 in multivariable models.Ferrara unfitness criteria provide a good prediction tool for shorter-term mortality after intensive AML chemotherapy. Our data may serve as a benchmark for expected outcomes with intensive chemotherapy in F-fit and F-unfit patients.
Dieulafoy lesion in the colon: a rare cause of lower gastrointestinal bleeding
Authors: José L. Paccos, Natália S. Mukai, Paulo A. F. P. Correa, Fernando P. Marson, Fernando L. Mota, Fernando J. Savóia de Oliveira, Eduardo M. A. Pereira Junior
Journal: Endoscopy (2020)

Dieulafoy lesion is an uncommon cause of gastrointestinal bleeding [1] [2]. It is most often located in the proximal portions of the gastrointestinal tract, but unusual locations such as the colon have also been reported. It is defined by a large and tortuous submucosal arteriole that protrudes through the mucosal layer and may be a cause of massive and recurrent bleeding [3] [4]. The clinical presentation is variable and consists of hematemesis, melena, hematochezia, enterorrhagia, or anemia of unknown cause [4]. Common endoscopic findings are the presence of a superficial protruding vessel in a small mucosal defect (with or without active bleeding) and the presence of fresh clot adherent to a tiny defect in the normal gastrointestinal mucosa [3] [4].
The optimal living and survivorship program: Piloting a novel survivorship care model.
Authors: Stacie Corcoran, John Russell, Jill Clayton, Bridget Kelly, Andrea Smith, Kate Keenan, Mark E. Robson, Neil M. Iyengar
Journal: Journal of Clinical Oncology (2020)

40 Background: Multiple agencies define cancer survivorship as beginning at the time of diagnosis. However, traditional care models deliver “survivorship care” months or years after diagnosis, which can cause care disruption and “transition anxiety”. We hypothesized that an approach centered around wellbeing could be applied across the cancer continuum (starting at diagnosis) and serve as a novel survivorship care model. Methods: We developed the Optimal Living and Survivorship Program with 3 key components: 1) a centralized model that provides multidisciplinary care; 2) an individualized Wellness Plan (WP); and 3) enrollment at the time of diagnosis to mitigate post-treatment transition. Participants complete a digital wellness questionnaire (WQ) prior to the 1st medical oncology consult, receive a validated algorithm-based WP, and meet with a Wellness Advanced Practice Provider (WAPP). The WP consists of individualized education and referrals (e.g., nutrition, exercise, financial counseling). The WAPP will assume post-treatment (“survivorship”) care. We piloted this approach in patients diagnosed with breast cancer beginning in 11/19. The primary outcome is feasibility defined by completion of the WQ. Secondary outcomes include participation in the WAPP visits, attendance at appointments, and quality of life (QOL). Results: Due to COVID-19, the pilot was paused in 2/20. Data collected from 11/19 through 2/20 reveal a total of 67 eligible patients with newly diagnosed breast cancer were approached, with 65 enrolled. All participants completed the WQ and all received a WP with supportive referrals and educational resources. All participants engaged with WP recommendations. Participants were screened at high risk for an average of 3.8 unmet needs, and 98% were at high risk for 2 or more needs at time of diagnosis. Exercise was the highest unmet need (83%). There was 76% adherence with referral to the program’s Exercise Physiologist. Other areas of needs were nutrition (59%) and sleep quality (51%). WAPP tele-visits began in 6/20; visit completion rates will be presented. Qualitative data regarding patient experience and QOL will be obtained via interviews and feedback will be categorized in thematic domains. Conclusions: Most patients enrolled in the program, completed a WQ and engaged with the WP. Our findings suggest that this early intro to survivorship is feasible. Earlier engagement and incorporation of wellness and supportive services from time of diagnosis may improve our ability to address multifactorial needs during and after cancer therapy.
Treatment Outcomes in Chronic Myeloid Leukemia: Does One Size Fit All?
Authors: Alejandro Garcia-Horton, Jeffrey H. Lipton
Journal: Journal of the National Comprehensive Cancer Network (2020)

With the success of tyrosine kinase inhibitors (TKIs) in achieving next-to-normal overall survival in chronic myeloid leukemia (CML), treatment-free remission (TFR) has become a significant goal in the management of this disease. Discontinuation of therapy is attractive to both patients and physicians because maintaining a stable BCR-ABL transcript level without therapy would imply true operational CML cure. With TFR, patients are not exposed to unknown long-term adverse effects of TKIs and common adverse effects that may affect quality of life. Several factors need to be considered before attempting TFR, because this goal is not appropriate for a significant proportion of patients with CML. Patient-related factors, CML response to therapy and its duration, monitoring capacity, patient preferences and compliance with monitoring, and economic factors influence the decision to attempt to discontinue TKIs. Unfortunately, only 50% of patients are appropriate candidates for discontinuation of treatment. Of those, another 50% maintain stable disease while off TKIs. This means that merely 25% of patients achieve TFR. Further optimization and research are required to be able to extend this treatment goal to a larger population of patients. Although TFR is attractive and desirable, this goal is not a one-size-fits-all approach, and we should continue to focus on patients with CML having a normal OS with the best quality of life possible.
New Smart Antimicrobial Hydrogels, Nanomaterials, and Coatings: Earlier Action, More Specific, Better Dosing?
Authors: Lorène Tallet, Varvara Gribova, Lydie Ploux, Nihal Engin Vrana, Philippe Lavalle
Journal: Advanced Healthcare Materials (2020)

Abstract To fight against antibiotic‐resistant bacteria adhering and developing on medical devices, which is a growing problem worldwide, researchers are currently developing new “smart” materials and coatings. They consist in delivery of antimicrobial agents in an intelligent way, i.e., only when bacteria are present. This requires the use of new and sophisticated tools combining antimicrobial agents with lipids or polymers, synthetic and/or natural. In this review, three classes of innovative materials are described: hydrogels, nanomaterials, and thin films. Moreover, smart antibacterial materials can be classified into two groups depending on the origin of the stimulus used: those that respond to a nonbiological stimulus (light, temperature, electric and magnetic fields) and those that respond to a biological stimulus related to the presence of bacteria, such as changes in pH or bacterial enzyme secretion. The bacteria presence can induce a pH change that constitutes a first potential biological trigger allowing the system to become active. A second biological trigger signal consists in enzymes produced by bacteria themselves. A complete panel of recent studies will be given focusing on the design of such innovative smart materials that are sensitive to biological triggers.