tbuckley/cabot-search huggingface dataset:
P14.86 Predictive value of MGMT promoter (pMGMT) methylation status on pseudoprogression (PsP) and survival analysis in Glioblastoma (GBM) patients: a retrospective single institutional analysis
Authors: V Interno’, P De Santis, L Stucci, C Porta
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Glioblastoma is the most common and aggressive primary brain tumor. Conventional therapies, such as maximal extension of surgery followed by radiotherapy (RT) and chemotherapy with Temozolomide (TMZ) have not resulted in major improvements in terms of patients’ outcome, overall survival (OS) still remaining poor. In this context, radiological response assessment after radiotherapy remains challenging due to the potential effect of radionecrosis, often mimicking tumor progression. Differentiation between PsP and true progression is required to avoid further unnecessary surgeries, or the premature discontinuation of TMZ. It is known that pMGMT methylated patients respond better to chemotherapy than unmethylated counterpart, so, tumor cells necrosis can be enhanced in this setting. The aim of the study is to observe the correlation between pMGMT methylation status with the incidence of PsP in GBM patients at the first radiological evaluation after RT. MATERIALS AND METHODS Patients with histologically diagnosis of GBM from 2017 to 2021 and availability of pMGMT methylation status were enrolled. PsP was radiologically defined at first brain MRI after RT in case of increasing size of the enhancing component and of peritumoral oedema that remain stable or decrease after antioedema therapy, such as a clinical improvement was observed. RESULTS We analysed 55 GBM patients, 35 (64%) displayed pMGMT methylation whereas 20 (36%) resulted pMGMT unmethylated. PsP was evident in 29 patients (53%), all of them showed methylation of pMGMT. In our analysis, none of pMGMT unmethylated patients experienced PsP. Regarding survival outcome for pMGMT methylated patients, our analysis shows a mPFS of 8.7 (95% CI: 5–10) months versus 9.3 (95%CI: 4.6–12.3) months in methylated and unmethylated respectively (p=0.87). CONCLUSIONS Methylation status of pMGMT showed to be predictor of PsP in GBM patients. If validated, this information could be very useful to guide clinicians in differentiating PsP from true progression. To date, our survival analysis regarding PFS showed no statistical difference among methylated patients with respect to the presence or absence of PsP. Thus, PsP seems not to be a marker of responsiveness to common treatment. Further data are needed to validate our results.
Seroprevalence of ancestral and Beta SARS-CoV-2 antibodies in Malagasy blood donors
Authors: Solohery Lalaina Razafimahatratra, Mame Diarra Bousso Ndiaye, Lova Tsikiniaina Rasoloharimanana, Philippe Dussart, Paquerette Hanitriniala Sahondranirina, Zely Arivelo Randriamanantany, Matthieu Schoenhals
Journal: The Lancet Global Health (2021)
Percutaneous Intervention in Acute Renal Attack
Authors: A.Q.M Reza
Journal: Clinical Cardiology and Cardiovascular Interventions (2021)

A young patient with renal infarction presented with right lower abdominal pain due to renal artery thrombosis is a rare clinical condition that warrants epidemiologic, clinical, angiographic, and prognostic importance. The patient’s condition was acute and was featured with abdominal pain, leukocytosis, and minimal renal impairment. The case presented here enabled us to widened our vision with patients presented with abdominal pain should warrant clinical suspicion about renal infarction although this is a rare clinical entity.
Auto-weighted centralised multi-task learning via integrating functional and structural connectivity for subjective cognitive decline diagnosis
Authors: Baiying Lei, Nina Cheng, Alejandro F. Frangi, Yichen Wei, Bihan Yu, Lingyan Liang, Wei Mai, Gaoxiong Duan, Xiucheng Nong, Chong Li, Jiahui Su, Tianfu Wang, Lihua Zhao, Demao Deng, Zhiguo Zhang
Journal: Medical Image Analysis (2021)
OS03.5.A Corelation between longitudinal t2 MRI radiomic primary texture feature values and radiation dose in non-tumoral regions of the brain in paediatric brain tumours
Authors: P Sakhavalkar, S Avula, B Pizer, N Thorp, M Jenkinson
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Paediatric brain tumour survivors may have treatment toxicity associated with signal change on follow-up MRI. Quantitative MRI texture features can potentially be used as surrogates of the underlying tissue changes following radiation therapy. MATERIAL AND METHODS Longitudinal retrospective study in 51 paediatric primary brain tumours treated with photon (N=30) and proton (N=21) radiotherapy (RT). T2 MRI scans at baseline and multiple time point from the date of surgery to 2 years following radiotherapy were selected for the textural analysis. Scans were bias corrected, registered with the CT dose maps and with baseline scan for each patient using 3Dslicer. Regions of interest (ROI) of fixed diameter were drawn in 11 predetermined non-tumoral regions of brain including in peri-tumoural region (PTV). ROIs were placed in homogenous white/grey matter. Radiation dose was calculated in each of these 11 ROIs and texture features were extracted using pyradiomics. Data were analysed using machine learning and statistical analysis. General linear multivariate model was used to corelate primary texture features over period of 24 months and radiation dose, time, effect of dose*time together at each ROI separately. RESULTS There were Brainstem 4, Cerebellar19, Hemispheric cerebral 7 and Supratentorial midline 10 tumours. Median age at diagnosis was 8.26 years (range: 0–20). Median RT treatment dose was 28.52Gy (0-60Gy). Multivariate analysis shows significant corelation (p &amp;lt; 0.001) between radiation dose and longitudinal primary texture features in all 11ROIs. Time showed corelation with feature values only in 3 ROIs and dose* time showed corelation in 5ROIs. Primary (statistical) feature values showing consistent correlation with dose in all 11 ROIs over 24 months are total energy, 10%, 90%, energy, entropy, mean, median, and minimum. CONCLUSION Radiomic texture analysis is a promising modality to understand dose related textural changes in the normal part of brain in paediatric brain tumour patients treated with radiation therapy. Radiomic changes need to be related to neurological outcomes in future research.
A Biomarker-Based Score for Risk of Hospitalization for Heart Failure in Patients With Diabetes
Authors: David D. Berg, Stephen D. Wiviott, Benjamin M. Scirica, Thomas A. Zelniker, Erica L. Goodrich, Petr Jarolim, Ofri Mosenzon, Avivit Cahn, Deepak L. Bhatt, Lawrence A. Leiter, Darren K. McGuire, John P.H. Wilding, Per Johanson, Anna Maria Langkilde, Itamar Raz, Eugene Braunwald, Marc S. Sabatine, David A. Morrow
Journal: Diabetes Care (2021)

Heart failure (HF) is an impactful complication of type 2 diabetes mellitus (T2DM). We aimed to develop and validate a risk score for hospitalization for HF (HHF) incorporating biomarkers and clinical factor(s) in patients with T2DM.
SRSF1 plays a critical role in invariant natural killer T cell development and function
Authors: Jingjing Liu, Menghao You, Yingpeng Yao, Ce Ji, Zhao Wang, Fang Wang, Di Wang, Zhihong Qi, Guotao Yu, Zhen Sun, Wenhui Guo, Juanjuan Liu, Shumin Li, Yipeng Jin, Tianyan Zhao, Hai-Hui Xue, Yuanchao Xue, Shuyang Yu
Journal: Cellular and Molecular Immunology (2021)
Breast Cancer, <i>HER2</i> Mutations, and Overcoming Drug Resistance
Authors: Ron Bose, Cynthia X Ma
Journal: New England Journal of Medicine (2021)

A recent study suggests that HER2-mutated breast cancer may develop resistance to drugs that inhibit the tyrosine kinase domain of HER2 through developing mutations in HER3, which enhance the dimerization between HER2 and HER3. The HER3 mutations augment signaling. This study supports a specific approach to overcoming mutant-HER3–mediated resistance.
Association Between Physician Part-time Clinical Work and Patient Outcomes
Authors: Hirotaka Kato, Anupam B. Jena, Jose F. Figueroa, Yusuke Tsugawa
Journal: JAMA Internal Medicine (2021)

<h3>Importance</h3> Despite the growing number of physicians who reduce clinical time owing to research, administrative work, and family responsibilities, the quality of care provided by these physicians remains unclear. <h3>Objective</h3> To examine the association between the number of days worked clinically per year by physicians and patient mortality. <h3>Design, Setting, and Participants</h3> This cross-sectional analysis was completed on a 20% random sample of Medicare fee-for-service beneficiaries 65 years and older who were admitted to the hospital with an emergency medical condition and treated by a hospitalist in 2011 through 2016. Because hospitalists typically work in shifts, hospitalists’ patients are plausibly quasirandomized to hospitalists based on the hospitalists’ work schedules (natural experiment). The associations between hospitalists’ number of days worked clinically per year and 30-day patient mortality and readmission rates were examined, adjusting for patient and physician characteristics and hospital fixed effects (effectively comparing physicians within the same hospital). Data analysis was conducted from July 1, 2020, to July 2, 2021. <h3>Exposures</h3> Physicians’ number of days worked clinically per year. <h3>Main Outcomes and Measures</h3> The primary outcome was 30-day patient mortality, and the secondary outcome was 30-day patient readmission. <h3>Results</h3> Among 392 797 hospitalizations of patients treated by 19 170 hospitalists (7482 female [39.0%], 11 688 male [61.0%]; mean [SD] age, 41.1 [8.8] years), patients treated by physicians with more days worked clinically exhibited lower mortality. Adjusted 30-day mortality rates were 10.5% (reference), 10.0% (adjusted risk difference [aRD], −0.5%; 95% CI, −0.8% to −0.2%;<i>P</i> = .002), 9.5% (aRD, −0.9%; 95% CI, −1.2% to −0.6%;<i>P</i> &lt; .001), and 9.6% (aRD, −0.9%; 95% CI, −1.2% to −0.6%;<i>P</i> &lt; .001) for physicians in the first (bottom), second, third, and fourth (top) quartile of days worked clinically, respectively. Readmission rates were not associated with the numbers of days a physician worked clinically (adjusted 30-day readmissions for physicians in the bottom quartile of days worked clinically per year vs those in the top quartile, 15.3% vs 15.2%; aRD, −0.1%; 95% CI, −0.5% to 0.3%;<i>P</i> = .61). <h3>Conclusions and Relevance</h3> In this cross-sectional study, hospitalized Medicare patients treated by physicians who worked more clinical days had lower 30-day mortality. Given that physicians with reduced clinical time must often balance clinical and nonclinical obligations, improved support by institutions may be necessary to maintain the clinical performance of these physicians.
Detection of Unilateral Axillary Nodal Uptake Both at 68Ga-DOTATOC and 18F-FDG PET/CT After 1 Week From COVID-19 Vaccine
Authors: Priscilla Guglielmo, Simona Muccioli, Sara Berti, Alida Sartorello, Fiammetta Pesella, Michele Gregianin
Journal: Clinical Nuclear Medicine (2021)

Abstract Recently, vaccination against COVID-19 has gained wide diffusion, especially among vulnerable individuals, such as cancer patients. At the same time, patients have been undergoing PET/CT examinations after vaccination in an increasing number, and cases of false-positive axillary nodal uptake have been described, mostly at 18 F-FDG PET. Here, we describe the case of both 68 Ga-DOTATOC and 18 F-FDG axillary nodal uptake in a young woman affected by a metastatic retroperitoneal paraganglioma.
OS06.9A Diversity of cellular communication in glioblastoma
Authors: K Joseph, L Vollmer, V M Ravi, J Beck, U G Hofmann, O Schnell, D H Heiland
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Owing to recent advances in understanding of the active functional states exhibited within glioblastoma (GBM), intra-tumoral cellular signaling has moved into focus of neuro-oncological research. In our study, we aim to explore the diversity of transcellular signaling and investigate correlations to transcriptional dynamics and cellular behavior. MATERIAL AND METHODS Electrophysiological mapping of primary GBM cultures was performed by planar microelectrodes, in conjunction with calcium imaging in a human neocortical section based GBM model. Exposure to conditions that are physiologically present within the tumor was carried out to identify specific signaling cells of interest and signaling diversity presented as response to specific environmental conditions. Transcriptional dynamics and plasticity were examined by means of scRNA-sequencing with CRISPR based perturbation, spatial transcriptomics and deep long-read RNA-sequencing. RESULTS Electrophysiological profiles of primary GBM cell lines revealed highly variable network activity. Despite these different characteristics, all profiled primary cell-lines exhibited characteristics of scale-free networks, confirmed in a human neocortical GBM model. When the GBM was allowed to grow in “in-vivo” like environment, basal activity was significantly increased, owing to interactions with elements within the neural environment. Cellular signaling was directly correlated to changes in the environment, like hypoxia or glutamatergic activation, and total inhibition of electrical signaling was achieved only with a combination of both gap junction and synaptic inhibitors. Using single-cell sequencing and proteomics, we identified several genes related to synaptogenesis that plays a crucial role in network formation and consequently transcellular signaling. CRISPR based perturbation of these genes resulted in alterations in cellular morphology and decreased cellular connectivity, with electrical signaling being significantly attenuated. Single-cell sequencing of perturbed tumor cells in the GBM model revealed a loss of developmental lineages and significant reduction of cellular stress response state. CONCLUSION Our findings highlight the role of electrical signaling in glioblastoma. Cellular stressors induce intercellular signaling, leading to transcriptional adaptation suggesting that there exists a highly complex and powerful mechanism for dynamic transcriptional state adaptation.
Health-Related Digital Autonomy. A Response to the Commentaries
Authors: Sebastian Laacke, Regina Mueller, Georg Schomerus, Sabine Salloch
Journal: The American Journal of Bioethics (2021)

This article refers to:Artificial Intelligence, Social Media and Depression. A New Concept of Health-Related Digital AutonomyThe Coercive Potential of Digital Mental HealthA New Type of 'Greenwashing'? Social Media Companies Predicting Depression and Other Mental IllnessesIs Health-Related Digital Autonomy Setting the Autonomy Bar Too High?The Right to Contest AI Profiling Based on Social Media DataFour Stages in Social Media Network Analysis—Building Blocks for Health-Related Digital Autonomy in Artificial Intelligence, Social Media, and DepressionBlack Boxes and Bias in AI Challenge AutonomyError, Reliability and Health-Related Digital Autonomy in AI Diagnoses of Social Media AnalysisHealth-Related Digital Autonomy: An Important, But Unfinished StepConsultation with Doctor Twitter: Consent Fatigue, and the Role of Developers in Digital Medical EthicsArtificial Intelligence, Social Media, and Suicide Prevention: Principle of Beneficence Besides Respect for Autonomy
Hyperglycemia in acute COVID-19 is characterized by insulin resistance and adipose tissue infectivity by SARS-CoV-2
Authors: Moritz Reiterer, Mangala Rajan, Nicolás Gómez-Banoy, Jennifer D. Lau, Luis G. Gomez-Escobar, Lunkun Ma, Ankit Gilani, Sergio Alvarez-Mulett, Evan T. Sholle, Vasuretha Chandar, Yaron Bram, Katherine Hoffman, Priya Bhardwaj, Phoebe Piloco, Alfonso Rubio-Navarro, Skyler Uhl, Lucia Carrau, Sean Houhgton, David Redmond, Alpana P. Shukla, Parag Goyal, Kristy A. Brown, Benjamin R. tenOever, Laura C. Alonso, Robert E. Schwartz, Edward J. Schenck, Monika M. Safford, James C. Lo
Journal: Cell Metabolism (2021)
P12.09 Clinical features and management of normal pressure hydrocephalus associated with non-obstructive vestibular schwannoma
Authors: V Redaelli, P Gaviani, G Simonetti, A G Botturi, M Marchetti, M A Broggi, A Silvani
Journal: Neuro-Oncology (2021)

Abstract BACKGROUND Some (elderly) patients present a communicating (normal pressure) hydrocephalus (NPH) in association with or secondary to vestibular schwannoma (VS). We aim to investigate the usefulness ventriculo-peritoneal shunt (VPS) without tumor removal. MATERIALS AND METHODS 8 patients aged from 50 to 78 years received both diagnosis of VS (mean maximum diameter 21 mm, range 13–28 mm) and NPH. None presented the classical Hakim’s triad. They presented isolated ataxia with gait impairment and loss of equilibrium. It was hard to distinguish if these symptoms were due to NPH or to VIII cranial nerve compression. They underwent TAP test, through a lumbar puncture with a very slow whithdrawal of at least 30 ml of cerebrospinal fluid (CSF). RESULTS None of the 8 patients presented improvement after lumbar puncture. Despite this, we decided to proceed with VPS in 4 patients because of a high risk of falls.... All these 4 patients showed clinical improvement after VPS.. The VS were treated as follows: 4 surgery, 2 radiosurgery, 2 observation. CONCLUSIONS Although some authors indicate VS removal as the best option to improve also NPH symptoms, some patients present high risk of falls in the presence of a small VS. These clinical features are more likely to be relayed related to NPH instead of VS.. VPS carries lower postoperative risks compared to VS removal. For this reason, VPS has to be considered, even without a positive response to a TAP test, as a good alternative to improve quality of life in patient affected by NPH associated with VS.
Serious illness conversation and end of life care utilization at an academic medical center.
Authors: William P. Tompkins, Christine Agnes Ciunci, Suzanne Walker, Kelly Patton, Amy Schwartz, Christopher Davella
Journal: Journal of Clinical Oncology (2021)

29 Background: Hospice has been associated with improved quality of life for patients, cost savings, and reduction in caregiver-grief-related depression. While cancer patients make up a plurality of hospice utilizers nationally, many patients are only on hospice for a limited period (in Medicare patients, a median of 18 days). Studies suggest engaging cancer patients to discuss goals and priorities using the Serious Illness Conversation (SIC) Guide has a positive impact on prognostic understanding and end-of-life planning. More frequent utilization of SICs may prompt earlier enrollment of oncology patients in hospice when appropriate. Methods: We identified cancer patients enrolled in hospice at the Abramson Cancer Center at Penn Presbyterian Medical Center from 2019-2020 after all providers received SIC training. Patient demographics, cancer diagnosis, type of hospice (home versus inpatient), SIC usage, palliative care referral patterns and time on hospice were abstracted. Results: 104 patients were enrolled in hospice during the study period. The majority of patients were female (51%). 45% were Caucasian, and 31% were African American. The most common cancer diagnoses were thoracic (52%) and gastrointestinal (32%) malignancies. 85 patients (82%) were enrolled on home hospice and 19 patients (18%) inpatient hospice. Palliative care usage included 50 inpatient and 24 outpatient consultations; 30 patients (29%) in the cohort never utilized palliative care. 52 (50%) of patients did not have a SIC. 47% (40 patients) enrolled in home hospice had an SIC while 63% (12 patients) on inpatient hospice had an SIC. The median time interval between a patient’s SIC conversation and hospice enrollment was longer in home hospice patients (74 days) compared to inpatient hospice (33 days). Patients on home hospice spent an average of 44 days on hospice versus 2 days in the inpatient setting. Conclusions: Half of the patients at Penn Presbyterian Medical Center enrolled in hospice during the study period did not have an SIC, and 29% did not see palliative care prior to starting hospice. The median time from SIC initiation to hospice enrollment was significantly longer for patients on home hospice compared to inpatient hospice suggesting a need for earlier SIC interventions. Patients enrolled in inpatient hospice spent a considerably shorter period of time on hospice also underscoring the importance of earlier end of life planning. Our findings indicate a need for additional interventions to facilitate earlier SIC conversations in the outpatient setting and a demand for increased palliative care access.
Decline of tuberculosis notification rate in different populations and regions in Portugal, 2010–2017
Authors: A. Sentís, A. Prats-Uribe, V.R. Peixoto, J.A. Caylà, M.D. Gomes, S. Sousa, R. Duarte, I. Carvalho, C. Carvalho
Journal: Pulmonology (2021)

Tuberculosis (TB) incidence declined in Portugal in recent decades, but trends differ between regions and population subgroups. We investigated these differences to inform prevention and control programmes. We extracted TB notifications from the Portuguese National TB Surveillance System (SVIG-TB) in 2010–2017, disaggregated by region, age group, nationality and HIV status. We calculated notification rates using denominators from the Portuguese National Institute of Statistics and the Joint United Nations Programme on HIV/AIDS and performed stratified time series analysis. We estimated interannual decline percentages and 95% confidence intervals (CI) using Poisson and binomial negative regression models. The overall TB notification rate decreased from 25.7 to 17.5/100,000 population from 2010 to 2017 (5.2%/year) in Portugal. Interannual decline did not differ significantly between regions, but it was smaller amongst non-Portuguese nationals (-1.57% [CI: -4.79%, 1.75%] vs -5.85% [CI: -6.98%, -4.70%] in Portuguese nationals); children under five years of age (+1.77% [CI: -4.61%, 8.58%] vs -5.38% [CI: -6.33%, -4.42%] in other age groups); and HIV-negative people (-6.47% [CI: -9.10%, -3.77%] vs -11.29% [CI; -17.51%, -4.60%] in HIV-positive). The decline in TB notification rates in Portugal during the study period has been steady. However, the decline amongst non-Portuguese nationals, children under five years of age and non-infected-HIV patients was lower. No significant differences were observed between regions. Changes in TB epidemiology in specific risk groups and geographical areas should be closely monitored to achieve the objectives of the End TB Strategy. We recommend intensifying screening of TB in the subpopulations identified.
How to Manage Patients With Cardiac Implantable Electronic Devices Undergoing Radiation Therapy
Authors: Michael G. Fradley, Bénédicte Lefebvre, Joseph Carver, Jim W. Cheung, Steven J. Feigenberg, Rachel Lampert, Jennifer Liu, Bharath Rajagopalan, Daniel J. Lenihan
Journal: JACC CardioOncology (2021)