tbuckley/cabot-search huggingface dataset:
Safety evaluation of M9241 in combination with docetaxel in metastatic prostate cancer.
Authors: Mohammad O. Atiq, Elias Bin Aris Chandran, Luke Meininger, Fatima Karzai, Marijo Bilusic, Jennifer L. Marte, Philip M. Arlen, Lisa M. Cordes, Julius Strauss, Jason Redman, Charalampos S. Floudas, Danielle M. Pastor, Helen Owens, Amy Hankin, Monique Williams, William Douglas Figg, William L. Dahut, Jeffrey Schlom, James L. Gulley, Ravi Amrit Madan
Journal: Journal of Clinical Oncology (2022)

93 Background: M9241 is an immunocytokine that targets single- and double-stranded DNA which allows the treatment to localize IL-12 to necrotic tumor (Xu, CCR 2017). M9241 was well-tolerated as a monotherapy in a Phase I study with solid tumors (Strauss J, CCR 2019). Additional preclinical data has demonstrated synergy of M9241 with cytotoxic therapy. This is the first study to examine the safety of a novel combination of chemotherapy and immunocytokines in metastatic prostate cancer. Methods: This safety analysis included patients with mCSPC or mCRPC. Patients were enrolled in a 2-dose level (DL) escalation cohort of M9241 (DL 1: 12mcg/kg, DL 2: 16.8mcg/kg) combined with docetaxel (75mg/m 2 ) with 6 patients planned per DL. A third DL of 8mcg/kg will enroll 6 more patients after the 16.8mcg/kg DL has fully enrolled. All patients were treated with ADT. Patients were initiated on treatment with docetaxel with a plan for mCSPC patients to receive six 3-week cycles of combined treatment and mCRPC patients to continue until progression or unacceptable toxicity. M9241 was given starting with the second cycle of treatment for each patient. Dose-limiting toxicity (DLT) was evaluated in the first 6 weeks after start of docetaxel (from cycle 1 day 1 through the end of the first cycle with M9241). Results: The study has enrolled 10 patients out of a planned 18 for the safety portion. Age range is 58-82 with a median of 69 years. Race distribution is 80% White and 20% Black. Gleason scores for patients were 8 (40%), 9 (40%), and 10 (20%). No DLTs were seen with either dose-level. Only 1 patient had a Grade 4 AE, neutropenia. Grade 3 toxicities included anemia, diarrhea, leukopenia, and hypotension (each occurring in 10% of the patients). The most frequent adverse events (AEs) of any grade were anemia (40%) and lymphopenia (40%), followed by fatigue (30%), diarrhea (20%), and fever (20%). Conclusions: We established a safe dose-level of M9241 at ≥ 12mcg/kg. Updated clinical data from the safety cohort (n = 18) will be presented. This demonstrates that an immunocytokine and chemotherapy can be safely combined for treatment in metastatic prostate cancer. A planned expansion cohort will evaluate docetaxel and M9241 in mCRPC. Clinical trial information: NCT04633252.
Pseudoagglutination
Authors: W. H. S. George, D. Horton
Journal: BMJ (1963)

BRMSH 541 tives, usually poor palliatives at that, and in these circumstances any dosage carrying a 16% mortality rate is far too high.During 1959-61 1 treated well over a hundred cases with " thiotepa."Roughly one-third were given the high dosage (along with testosterone pro- pionate) recommended by Whyte Watson and Turner,' the remainder receiving about half this dosage.This experience convinced me that maximal doses do more harm than good.Dr. Basil A. Stoll is right in stressing the harmful effects of injudicious chemotherapy.2He writes of the " dangers of piling misery upon misery in the late cancer case."-I am, etc.,
Error in Results
Journal: JAMA Network Open (2022)

Error in ResultsIn the Original Investigation titled "Reasons for Suicide During the COVID-19 Pandemic in Japan," 1 published January 31, 2022, there was an error in the Results section.In the section describing subcategories of reason for suicide that had 1 month with an excess suicide rate among women, the excess suicide rate for work fatigue should have read 133.3%.This article has been corrected.
Building or Extending a Hospital Department: Radiology a Path through the Planning Minefield (6)
Authors: E J Roebuck, D J Manton, G L Fordham
Journal: Journal of the Royal Society of Medicine (1987)

This is the sixth of a series of articles on the planning and building of a new radiology department or the extension of an old one. While the series focuses on a radiology department, it will be of interest to anyone who is planning any part of a hospital, particularly in the detailed information about the planning process and the part to be played by hospital staff during the subsequent building and commissioning. (The first article in the series appeared in the January issue, p 40.)
Disparities in prostate cancer: An ethnicity comparative focus among Hispanic Americans versus non-Hispanic whites.
Authors: Alejandro Recio-Boiles, Ken Batai, Ce Cheng, Ronald Heimark, Juan Chipollini
Journal: Journal of Clinical Oncology (2022)

23 Background: Prostate cancer (PCa) is a clinically heterogeneous disease and the incidence and mortality risk varies widely among racial/ethnic groups. Among Hispanic American (HA) men, PCa accounts for nearly one-quarter of the total cancer burden; in addition, advanced stage and mortality rates are significantly higher in HA compared to Non-Hispanic White (NHW) men. Despite a decade of declining overall incidence rates, incidence rates of advanced PCa appear to be increasing over time among HA men, a similar pattern seen among Non-Hispanic Blacks (NHB). Methods: Using the National Cancer Database, we identified patients with histologically confirmed prostate adenocarcinoma with reported race/ethnicity, clinical staging, Gleason score ≥ 6, and PSA at diagnosis between 2010 and 2016. HAs were divided into four major subgroups: Mexican/Chicano, Puerto Ricans, Cubans, and Central/South Americans. NHB, Asian, and other racial groups were excluded. Statistical analysis was derived from the Kruskal-Wallis test for continuous variables and χ 2 test for categorical variables. Univariable and multivariable logistic regression models were used to evaluate the association of HA ethnic subgroups with metastatic presentation and primary treatment. Results: A total of 428,829 patients were included with 5,625 (1.3%) being HA. Mexican comprised 51.2% of HAs and presented with higher PSA and Gleason score at diagnosis and more advanced cT, N1 and M1 stage when compared to NHW men and other HA subgroups (all, p &lt; 0.001) (Table). After adjusting for age, PSA, year of diagnosis, cT, N, insurance, income, education, and performance score, Mexican had 1.32 (95%CI: 1.07-1.63, p = 0.01) higher odds of initial metastatic presentation and 0.68 (95%CI: 0.55-0.85, p &lt; 0.001) lower odds of receiving treatment compared to NHW men while no statistically significant difference was seen for the other HA subgroups. Conclusions: Even after accounting for socioeconomic disparities, Mexican men present with a more aggressive disease when compared to NHW and other HA subgroups. Our results warrant further investigations into potential biological factors affecting HA PCa as well as identifications of potential barriers to treatment for vulnerable populations.[Table: see text]
Abstract 272: Feasibility of Non-Invasive Cerebral Blood Flow Monitoring During CPR
Authors: Nathan Haas, Amanda Pennington, Ryan Coute, Robert Neumar
Journal: Circulation (2018)

Introduction: Reliable non-invasive monitoring of cerebral blood flow (CBF) during cardiac arrest would greatly facilitate goal-directed brain resuscitation during CPR. The Ornim c-FLOW™ provides real-time, continuous, non-invasive, direct monitoring of CBF via ultrasound tagged near infrared spectroscopy using adhesive sensors applied to the forehead. Values range from 0-100 units with a reported baseline value of 55±7 units (mean±sd). C-FLOW™ values are refreshed every three seconds for each of two forehead probes. The feasibility of using c-FLOW™ to monitor CBF during cardiac arrest has not been previously reported. Methods: The c-FLOW™ was applied in the ED to adult patients undergoing CPR for cardiac arrest that occurred in the ED or outside the hospital. c-FLOW™ values were continuously recorded during CPR and for up to 6 hours post-ROSC. c-FLOW™ values were correlated with corresponding end-tidal CO 2 (PetCO 2 ) values during CPR. Changes in c-FLOW™ values after vasopressor therapy were also quantified. Results: c-FLOW™ values were continuously recorded on patients undergoing CPR during 10 cardiac arrests. Initial, minimum, maximum, and mean values during CPR were 30.7±12.7, 17.3±15.0, 51.3±15.6, and 31.3±12.6 units, respectively. Maximum values after ROSC and VA ECMO were 43.0±10.9 and 59.0±12.0 units, respectively, and mean values after ROSC and VA ECMO were 24.0±11.7 and 35.3±12.7 units, respectively. The minimum value recorded after cessation of resuscitation efforts was 1.7±3.7 units. There was no significant correlation between c-FLOW™ values and simultaneous PetCO 2 values during CPR (R 2 0.01, p&gt;0.05). c-FLOW™ values increased 7.6±8.5 units after IV/IO epinephrine boluses during CPR, though increased less with each subsequent bolus. Conclusions: Application of the c-FLOW™, a continuous real-time monitor of CBF, during cardiac arrest is feasible in the ED setting. c-FLOW™ values suggest variable and dynamic CBF during CPR. c-FLOW™ values do not appear to correlate with PetCO 2 but appear to detect increases in CBF associated with vasopressor therapy during CPR. Future studies are needed to determine the value of continuous non-invasive CBF monitoring as part of a goal-directed strategy to optimize brain resuscitation during CPR.
Data Transformation in the Processing of Neuronal Signals: A Powerful Tool to Illuminate Informative Contents
Authors: MohammadAli Shaeri, Amir M. Sodagar
Journal: IEEE Reviews in Biomedical Engineering (2022)

Neuroscientists seek efficient solutions for deciphering the sophisticated unknowns of the brain. Effective development of complicated brain-related tools is the focal point of research in neuroscience and neurotechnology. Thanks to today's technological advancements, the physical development of high-density and high-resolution neural interfaces has been made possible. This is where the critical bottleneck in receiving the expected functionality from such devices shifts to transferring, processing, and subsequently analyzing the massive neurophysiological extra-cellular data recorded. To respond to this inevitable concern, a spectrum of neuronal signal processing techniques have been proposed to extract task-related informative content of the signals conveying neuronal activities, and eliminate the irrelevant contents. Such techniques provide powerful tools for a wide range of neuroscience research, from low-level perception to high-level cognition. Data transformations are among the most efficient processing techniques that serve this purpose by properly changing the data representation. Mapping the data from its original domain ( <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">i.e.</i> , the time-space domain) to a new representational domain, data transformations change the viewing angle of observing the informative content of the data. This paper reviews the employment of data transformations in order to process neuronal signals and their three key applications, including spike detection, spike sorting, and data compression.
Interventions to prevent spontaneous preterm birth in women with singleton pregnancy who are at high risk: systematic review and network meta-analysis
Authors: Angharad Care, Sarah J Nevitt, Nancy Medley, Sarah Donegan, Laura Good, Lynn Hampson, Catrin Tudur Smith, Zarko Alfirevic
Journal: BMJ (2022)

To compare the efficacy of bed rest, cervical cerclage (McDonald, Shirodkar, or unspecified type of cerclage), cervical pessary, fish oils or omega fatty acids, nutritional supplements (zinc), progesterone (intramuscular, oral, or vaginal), prophylactic antibiotics, prophylactic tocolytics, combinations of interventions, placebo or no treatment (control) to prevent spontaneous preterm birth in women with a singleton pregnancy and a history of spontaneous preterm birth or short cervical length.
Piflufolastat F 18-PET/CT in prostate cancer patients: An analysis of OSPREY (Cohorts A and B) standardized uptake value (SUV) results stratified by PSA and gleason score.
Authors: Michael A. Gorin, Steven P. Rowe, Kenneth J. Pienta, Peter R. Carroll, Frederic Pouliot, Stephan Probst, Lawrence Saperstein, Mark Preston, Ajjai Shivaram Alva, Akash Patnaik, Nancy Stambler, Barry A. Siegel, Michael J. Morris
Journal: Journal of Clinical Oncology (2022)

35 Background: The OSPREY clinical trial was a phase 2/3 prospective study of prostate specific membrane antigen (PSMA) PET/CT using piflufolastat F 18. Piflufolastat F 18 (aka 18 F-DCFPyL or PyL) is a novel PSMA-targeting radiopharmaceutical approved for imaging of PCa pts both at initial staging and for disease recurrence. Here we describe SUV results by biopsy status, baseline PSA levels, and Gleason score (GS). Methods: Piflufolastat F 18 -PET/CT was evaluated in men with NCCN high-risk PCa scheduled to undergo radical prostatectomy with pelvic lymphadenectomy (RP-PLND) (Cohort A) and men with radiologically suspected recurrent/metastatic PCa (Cohort B). A single IV dose of 9 mCi (333 MBq) of piflufolastat F 18 was administered followed by PET/CT acquisition 1-2 hours later. Piflufolastat F 18 uptake in various lesion locations as defined by maximum and peak SUV (SUVmax, SUVpeak) were determined by three blinded, independent central readers for each tissue (e.g., bone, lymph nodes (LN), soft tissue). To measure SUVs, the reader placed a volume of interest (VOI) on each identified lesion. SUVmax was defined as the maximum single-voxel SUV within the VOI. SUVpeak within the VOI was defined as the average SUV within a fixed-sized VOI (1 cm diameter sphere), representing the cluster with the highest average SUV. Results: 345 men underwent piflufolastat F 18-PET/CT. Cohort B (n = 93 evaluable) SUVmax and SUVpeak were significantly higher for biopsy positive (+) (one biopsy lesion/pt) when compared to biopsy negative (-) lesions from bone and LN. SUVpeak for biopsied bone and LN (Cohort B) appeared to increase with rising baseline PSA. In high-risk PCa pts, SUVpeak for prostate (Cohort A; n = 252 evaluable) increased with baseline PSA and were highest for GS 9-10 (Table). Conclusions: Piflufolastat F 18-PET/CT uptake was significantly higher in biopsy + lesions and increased with baseline PSA. Prostate SUVpeak was highest for GS 9-10. Clinical trial information: NCT02981368. [Table: see text]
Gonorrhea Among Men Who Have Sex With Men—Selected Sexually Transmitted Diseases Clinics, 1993-1996
Journal: JAMA (1997)

Among men who have sex with men (MSM), gonorrhea trends may reflect changes in sexual behaviors that also influence risk for human immunodeficiency virus (HIV) infection. Data from the Gonococcal Isolate Surveillance Project (GISP) were used to assess trends in gonococcal infection (GC) among MSM. For the subset of GISP sites where a substantial proportion of GC cases were in MSM, a special survey of the local areas was conducted to describe factors associated with GC in MSM. This report summarizes the results of that survey, which indicate that the number and proportion of MSM diagnosed with GC has increased in the sexually transmitted diseases (STD) clinics of several large cities in the United States.
Prescription charges.
Authors: C. J. Hart, I. H. Redhead
Journal: BMJ (1968)

BaJourhave worked in Indonesia, Uganda, and Korea.Barred from surgery in the United Kingdom, in Indonesia I found myself in sole charge of a 300-bedded hospital with around 200 outpatients a day, responsible for the surgery, medicine, obstetrics, etc., for a population of 45,000 persons, the only doctor in a large tract of land.Thus it is interesting to note that the Interview Board believes that non-specialists who undertake surgery add considerably to their income and interest, but that it "cannot always be in the best interest of the patients."I agree that the practice of surgery adds to one's interest, but working for the impoverished Indonesians I considered myself fortunate to receive the equivalent of 7s.6d. for a radical mastectomy.Further, I wonder on what
RBC destruction caused by a micropore blood filter
Authors: W. F. Schmidt
Journal: JAMA (1982)

Two infants who received whole blood filtered through commercially available woven stainless steel micropore filters experienced a sudden onset of hemoglobinuria. The plasma hemoglobin level in one child was 200 mg/dL. To investigate whether filters might lead to RBC destruction, we experimentally quantitated filter-induced hemolysis using standard conditions. Our studies in vitro show that hemolysis decreases with increased speed of transfusion. Hemolysis is particularly extensive with blood stored more than 14 days, but measurable hemolysis occurs with blood stored for as little as one day. (<i>JAMA</i>1982;248:1629-1632)
Abstract 264: Use of an Acronym to Reduce Medical Emergency Call Time and Improve Survival
Authors: Karen M Graves, Lee Anne Siegmund
Journal: Circulation (2018)

Introduction: An average of 1500 medical emergencies are called to the operators each month for the main campus Cleveland Clinic. Acronyms can help the employee to remember necessary information to quickly and accurately activate the right medical emergency team in a short time. We developed the acronym LEAN (L-Location, E-Event Type; code or rapid response, A-Adult or Child, N-Call back number). We reduced the length of the call which led to the prompt activation of the medical emergency team. Hypothesis: We hypothesized that this quality improvement initiative, using the LEAN acronym would: 1. Reduce length of call time to the operator and 2. Lead to increased event survival of event for patients who have had a life-threatening medical emergency. Methods: The LEAN acronym was implemented in 2016 by sharing this acronym at staff meetings, and daily huddles. We developed an operator scorecard which tracked the average call time to the 111 (code) and 122 (rapid response) operator lines before and after LEAN implementation. We used our AHA Get With The Guidelines-Resuscitation® data to determine cardiopulmonary arrest (CPA) event survival. Results: Since August of 2016 we have reduced our 122 rapid response calls by 30 seconds and our 111 code calls by 12 seconds. CPA survival rates were 73% (437 of 599) in 2015 and 78.9% (548 of 703) in 2017, for an 8.1% increase ( Figure 1 ). While there is not a statistically significant ( p = 0.511) difference between time periods when we look at percentage of lives saved, the number of lives saved increased. This is a clinically important difference because more people survived. We plan to continue to disseminate LEAN and work to improve response time. Conclusion: Since we introduced LEAN there has been a reduction in the time to activation of our medical emergency teams and an 8% increase in our GWTG-R® Cardiopulmonary Arrest event survival. Lives were saved and LEAN may have played a role in this clinically important difference.
A Case of Acromegaly
Authors: J. Barclay, Wm. St. C. Symmers
Journal: BMJ (1892)

s in the village of Whitehills, Banffshiie, where he lhas passed the greater part ~of his life, never having beea abroal or subjeeted to any climatic influences forEign to the coast (f the Moray Firth, flIe was a farm labourer bvoccupation.but has for many years been unable to do any work owing to the phy- sical condition which his disease has imposed %upon him.There is no- thing of any special me- dical interest in the history of his family, his father is still living, aged 74, his mother met her death by accident, -his five brothers and four sisters are all in ex- .cellenthealth and pre- 'sent no abnormalities.&o far as can be ascer- tained his more remote relatives are devoid of -sny special pathological interest.HIsToRY oF ILLNESS.The disease began ,when he was in his 25th year.His hands and feet -slowly grew larger, and the face and body un- derwent the process of -enlargement typical of this malady.At the commencement of his trouble he suffered from 'evere headaches.These continued for some four or five years, but gradu-
Objective Response by mRECIST to Initial Lenvatinib Therapy Is an Independent Factor Contributing to Deep Response in Hepatocellular Carcinoma Treated with Lenvatinib-Transcatheter Arterial Chemoembolization Sequential Therapy
Authors: Hidekatsu Kuroda, Takayoshi Oikawa, Masashi Ninomiya, Masashi Fujita, Kazumichi Abe, Kazuo Okumoto, Tomohiro Katsumi, Wataru Sato, Go Igarashi, Chikara Iino, Tetsu Endo, Nobukazu Tanabe, Hiroshi Numao, Shinsaku Fukuda, Katsunori Iijima, Atsushi Masamune, Hiromasa Ohira, Yoshiyuki Ueno, Yasuhiro Takikawa
Journal: Liver Cancer (2022)

There is limited information regarding the benefits of Lenvatinib-transcatheter arterial chemoembolization (LEN-TACE) sequential therapy for unresectable hepatocellular carcinoma (u-HCC). We compared the efficacy and safety of LEN-TACE sequential therapy to LEN monotherapy and investigated the factors contributing to the LEN-TACE sequential therapy deep response.We enrolled a multicenter cohort of 247 patients with u-HCC treated with LEN between 2018 and 2020. Propensity score matching identified 63 matching pairs of patients with well-balanced characteristics. We retrospectively compared the clinical outcomes, including overall survival (OS), progression-free survival (PFS), and incidence of adverse events (AEs), between the LEN-TACE and LEN monotherapy groups. Additionally, we evaluated the tumor response, change in albumin-bilirubin (ALBI) score, factors affecting PFS and OS, and independent predictors contributing to the LEN-TACE sequential therapy deep response. In this study, at eight weeks after resumption of LEN after initial TACE, "deep response" was defined as achieving complete response or partial response (PR) on modified Response Evaluation Criteria in Solid Tumors (mRECIST), and at least a 30% decrease in the sum of diameters of target lesions, taking the baseline sum diameters as the reference.The OS and PFS in the LEN-TACE group were significantly higher than those in the LEN monotherapy group (p = 0.002 and p = 0.037, respectively). The incidence of AEs related to LEN was not significantly different between the two groups. In LEN-TACE sequential therapy, the objective response rate was 61.9%, and the disease control rate was 74.6%, according to the mRECIST criteria. No significant change in the ALBI score was observed during sequential LEN-TACE therapy. Multivariable analyses revealed that deep response was independently associated with the outcome of the initial response to LEN by mRECIST: PR (odds ratio: 5.176, 95% confidence interval: 1.528-17.537, p < 0.001).LEN-TACE sequential therapy may provide more clinical benefits than LEN monotherapy in u-HCC patients who responded to initial LEN treatment. Objective response according to mRECIST to initial LEN is an independent factor contributing to LEN-TACE sequential therapy deep response.
A National University of the Health Sciences
Authors: L. M. Rousselot
Journal: JAMA (1969)

Aus military medical school has been a subject of discussion for at least 65 years; it was the subject of a major presentation at a meeting of the Association of Military Surgeons of the United States in 1903. Since 1953 Representative F. Edward Hebert of Louisiana has been the principal proponent of a military medical school. Uniformly this proposal has met with rejection not only by the armed services, but by the medical profession generally, and by medical educators particularly. The salient objections to a military medical school, documented in numerous responses and hearings, can be summarized somewhat as follows: A military medical academy is not a proper basis for the study of medicine. The least dogmatic of the professions, the curriculum of medical education is becoming more varied and abundant with every new class. Medicine is a profession which requires its practitioners to evaluate problems of disease in humans