Evaluating human exposure to aflatoxins: A case study on aflatoxinalbumin adduct levels in end stage liver disease patients in India

Aflatoxin B1, a secondary metabolite of Aspergillus flavus and A. parasiticus, is a frequent contaminant of several food crops. The main objective of this study was to know the effect of post exposure of aflatoxin in humans through consumption of contaminated foods. The aflatoxin-albumin level of selected human populations in India were analysed. A total of 673 blood samples were further analyzed by Indirect competitive Enzyme linked immunosorbent assay (IC-ELISA) method. The samples were collected along with clinical profile, demographic and food consumption data from the individuals with different stages of liver disease. The severity of the liver disease was calculated based on the “Model for End stage Liver Disesae” (MELD) score. The results indicated 86 of 673 samples have concentration of aflatoxin-albumin adduct ranged between 2.5 to 677 pg mg-1 of albumin with mean adduct level 181.9 ±5 and SD 1.49 ± 7. At 5% level of significance pb value 0.039 (<0.05) indicates presence of aflatoxin B1-lysine adducts and hepatitis B has synergistic effect on liver damage especially in end stage liver disease based on model for end stage liver disease (MELD). This shows that there is considerable intake of aflatoxin through contaminated food. Interestingly the concentration of aflatoxin-albumin was high and this along with the HBV positivity was found to be contributing to the severity of liver disease and lead to decompensated liver disease

Evaluating human exposure to aflatoxins: A case study on aflatoxinalbumin adduct levels in end stage liver disease patients in India

Aflatoxin B1, a secondary metabolite of Aspergillus flavus and A. parasiticus, is a frequent contaminant of several food crops. The main objective of this study was to know the effect of post exposure of aflatoxin in humans through consumption of contaminated foods. The aflatoxin-albumin level of selected human populations in India were analysed. A total of 673 blood samples were further analyzed by Indirect competitive Enzyme linked immunosorbent assay (IC-ELISA) method. The samples were collected along with clinical profile, demographic and food consumption data from the individuals with different stages of liver disease. The severity of the liver disease was calculated based on the “Model for End stage Liver Disesae” (MELD) score. The results indicated 86 of 673 samples have concentration of aflatoxin-albumin adduct ranged between 2.5 to 677 pg mg-1 of albumin with mean adduct level 181.9 ±5 and SD 1.49 ± 7. At 5% level of significance pb value 0.039 (<0.05) indicates presence of aflatoxin B1-lysine adducts and hepatitis B has synergistic effect on liver damage especially in end stage liver disease based on model for end stage liver disease (MELD). This shows that there is considerable intake of aflatoxin through contaminated food. Interestingly the concentration of aflatoxin-albumin was high and this along with the HBV positivity was found to be contributing to the severity of liver disease and lead to decompensated liver disease

Is there a positive effect of participation on a clinical trial for patients with advanced non-small cell lung cancer?

Background: There is general belief that patients who enrolled on a clinical trial have better outcomes compared to those who are treated outside of a trial. We analyzed if there was a \u2032trial effect\u2032 for patients with advanced non-small cell lung cancer (NSCLC) treated with chemotherapy. Materials and methods: A retrospective analysis of cohorts of patients with advanced NSCLC who received chemotherapy inside and outside of a clinical trial were analyzed for response rates (RR), progression free survival (PFS), overall survival (OS), 1 and 2 year survival. Results: There were 194 patients who received chemotherapy of which, 54 were on a clinical trial and 140 outside of it. For the whole group, the RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), 29.8% and 9.7% respectively. The differences in RR and PFS of patients who were treated inside and outside of a clinical trial were not significant (P=0.6164, 0.0881). The differences in median OS and one-year survivals between the groups were significant (P=0.0052, 0.022). For the whole group, patients who received II line chemotherapy had better OS (P\ua30.0001). More patients in the trial group received II line chemotherapy (P=0.0004).The difference in the median OS between the groups continued to be significant even after patients who received II line chemotherapy were censored (P=0.0437). Conclusion: Patients with advanced NSCLC who were treated inside of a clinical trial had better OS compared to those who were treated outside of it

Benchmarking classification techniques using the Opportunity human activity dataset

Human activity recognition is a thriving research field. There are lots of studies in different sub-areas of activity recognition proposing different methods. However, unlike other applications, there is lack of established benchmarking problems for activity recognition. Typically, each research group tests and reports the performance of their algorithms on their own datasets using experimental setups specially conceived for that specific purpose. In this work, we introduce a versatile human activity dataset conceived to fill that void. We illustrate its use by presenting comparative results of different classification techniques, and discuss about several metrics that can be used to assess their performance. Being an initial benchmarking, we expect that the possibility to replicate and outperform the presented results will contribute to further advances in state-of-the-art methods

The Opportunity challenge: A benchmark database for on-body sensor-based activity recognition

There is a growing interest on using ambient and wearable sensors for human activity recognition, fostered by several application domains and wider availability of sensing technologies. This has triggered increasing attention on the development of robust machine learning techniques that exploits multimodal sensor setups. However, unlike other applications, there are no established benchmarking problems for this field. As a matter of fact, methods are usually tested on custom datasets acquired in very specific experimental setups. Furthermore, data is seldom shared between different groups. Our goal is to address this issue by introducing a versatile human activity dataset recorded in a sensor-rich environment. This database was the basis of an open challenge on activity recognition. We report here the outcome of this challenge, as well as baseline performance using different classification techniques. We expect this benchmarking database will motivate other researchers to replicate and outperform the presented results, thus contributing to further advances in the state-of-the-art of activity recognition methods

Immunotherapy: is a minor god yet in the pantheon of treatments for lung cancer?

Immunotherapy has been studied for many years in lung cancer without significant results, making the majority of oncologists quite skeptical about its possible application for non-small cell lung cancer treatment. However, the recent knowledge about immune escape and subsequent 'cancer immunoediting' has yielded the development of new strategies of cancer immunotherapy, heralding a new era of lung cancer treatment. Cancer vaccines, including both whole-cell and peptide vaccines have been tested both in early and advanced stages of non-small cell lung cancer. New immunomodulatory agents, including anti-CTLA4, anti-PD1/PDL1 monoclonal antibodies, have been investigated as monotherapy in metastatic lung cancer. To date, these treatments have shown impressive results of efficacy and tolerability in early clinical trials, leading to testing in several large, randomized Phase III trials. As these results will be confirmed, these drugs will be available in the near future, offering new exciting therapeutic options for lung cancer treatment

Targeted Therapy for Medullary Thyroid Cancer: A Review

Medullary thyroid cancers (MTCs) constitute between 2 and 5% of all thyroid cancers. The 10-year overall survival (OS) rate of patients with localized disease is around 95% while that of patients with regional stage disease is about 75%. Only 20% of patients with distant metastases at diagnosis survive 10 years which is significantly lower than for differentiated thyroid cancers. Cases with regional metastases at presentation have high recurrence rates. Adjuvant external radiation confers local control but not improved OS. The management of residual, recurrent, or metastatic disease till a few years ago was re-surgery with local measures such as radiation. Chemotherapy was used with marginal benefit. The development of targeted therapy has brought in a major advantage in management of such patients. Two drugs—vandetanib and cabozantinib—have been approved for use in progressive or metastatic MTC. In addition, several drugs acting on other steps of the molecular pathway are being investigated with promising results. Targeted radionuclide therapy also provides an effective treatment option with good quality of life. This review covers the rationale of targeted therapy for MTC, present treatment options, drugs and methods under investigation, as well as an outline of the adverse effects and their management

Chemotherapy for advanced lung cancer: A 5-year experience

Background : Lung cancer is an important cause of cancer related deaths worldwide. There are few publications from India on treatment outcomes for non-small cell lung cancer (NSCLC). This study was done to analyze the response rates (RR), progression free survival (PFS), overall survival (OS), one and two-year survival of patients with advanced NSCLC treated with chemotherapy. Materials and Methods: Data of all patients who received chemotherapy for stage IIIB and IV NSCLC between the years 2002-2006 was analyzed. Only patients who received at least two cycles of chemotherapy and had a radiological response evaluation were eligible for assessment of outcome parameters. Results: There were 294 patients who received chemotherapy. Of these 194 (66%) were evaluable for outcome parameters. The RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), and 29.8% and 9.7% respectively. On univariate analysis, the strongest predictors for overall survival were female gender, absence of smoking and performance status (PS) (P= 0.0057, 0.0013, 0.0074). On multivariate analysis, only PS (P= 0.0387) was significant. The survival of patients treated with I generation platinum based doublet was not different from those treated with a II generation doublet (P= 0.45). The overall survival of patients who took II line chemotherapy was superior to those who did not receive it (P= < 0.0001). Conclusions: Treatment outcomes for patients with advanced NSCLC continue to be poor. The II generation platinum doublets were not superior to I generation doublets. Chemotherapy at disease progression significantly improves survival

Chemotherapy for advanced lung cancer: A 5-year experience

Background : Lung cancer is an important cause of cancer related deaths worldwide. There are few publications from India on treatment outcomes for non-small cell lung cancer (NSCLC). This study was done to analyze the response rates (RR), progression free survival (PFS), overall survival (OS), one and two-year survival of patients with advanced NSCLC treated with chemotherapy. Materials and Methods: Data of all patients who received chemotherapy for stage IIIB and IV NSCLC between the years 2002-2006 was analyzed. Only patients who received at least two cycles of chemotherapy and had a radiological response evaluation were eligible for assessment of outcome parameters. Results: There were 294 patients who received chemotherapy. Of these 194 (66%) were evaluable for outcome parameters. The RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), and 29.8% and 9.7% respectively. On univariate analysis, the strongest predictors for overall survival were female gender, absence of smoking and performance status (PS) (P= 0.0057, 0.0013, 0.0074). On multivariate analysis, only PS (P= 0.0387) was significant. The survival of patients treated with I generation platinum based doublet was not different from those treated with a II generation doublet (P= 0.45). The overall survival of patients who took II line chemotherapy was superior to those who did not receive it (P= &lt; 0.0001). Conclusions: Treatment outcomes for patients with advanced NSCLC continue to be poor. The II generation platinum doublets were not superior to I generation doublets. Chemotherapy at disease progression significantly improves survival

Chemotherapy for advanced lung cancer: A 5-year experience

Background : Lung cancer is an important cause of cancer related deaths worldwide. There are few publications from India on treatment outcomes for non-small cell lung cancer (NSCLC). This study was done to analyze the response rates (RR), progression free survival (PFS), overall survival (OS), one and two-year survival of patients with advanced NSCLC treated with chemotherapy. Materials and Methods: Data of all patients who received chemotherapy for stage IIIB and IV NSCLC between the years 2002-2006 was analyzed. Only patients who received at least two cycles of chemotherapy and had a radiological response evaluation were eligible for assessment of outcome parameters. Results: There were 294 patients who received chemotherapy. Of these 194 (66%) were evaluable for outcome parameters. The RR, median PFS, OS, one and two-year survivals were 35.4%, six months (range, 2-70), seven months (range, 2-72), and 29.8% and 9.7% respectively. On univariate analysis, the strongest predictors for overall survival were female gender, absence of smoking and performance status (PS) (P= 0.0057, 0.0013, 0.0074). On multivariate analysis, only PS (P= 0.0387) was significant. The survival of patients treated with I generation platinum based doublet was not different from those treated with a II generation doublet (P= 0.45). The overall survival of patients who took II line chemotherapy was superior to those who did not receive it (P= < 0.0001). Conclusions: Treatment outcomes for patients with advanced NSCLC continue to be poor. The II generation platinum doublets were not superior to I generation doublets. Chemotherapy at disease progression significantly improves survival