Miracle-dz/UniFAR-FTUs huggingface dataset:
Variation in colorectal cancer treatment and survival: a cohort study covering the East Anglia region

National guidelines for colorectal cancer management aim to optimize cancer outcomes irrespective of postcode. However, in order to ensure equal performance of cancer services, variation in outcome must be monitored and intelligently assessed. In this study, detailed regional cancer registry data were used to quantify and explore the reasons for variation in colorectal cancer outcomes at nine hospitals in East Anglia.
Long-term results of a randomized trial comparing three different devices for percutaneous closure of a patent foramen ovale.

AIMS Percutaneous patent foramen ovale (PFO) closure for secondary stroke prevention is discussed controversially. Long-term data comparing different closure devices are limited. The objective is the prospective comparison of procedural complications and long-term results after PFO closure in patients with cryptogenic stroke randomized to three different closure devices. METHODS AND RESULTS Between January 2001 and December 2004, 660 patients with cryptogenic stroke were randomized to three different closure devices (Amplatzer, CardioSEAL-STARflex, and Helex occluder, 220 patients per group). The primary endpoint was defined as recurrent cerebral ischaemia [stroke, transient ischaemic attacks (TIA), or Amaurosis fugax], death from neurological cause, or any other paradoxical embolism within 5 years after the index procedure. Device implantation was technically successful in all interventions (n = 660; 100%). The procedure was complicated by pericardial tamponade requiring surgery in one patient (Amplatzer group) and device embolization in three patients (all Helex group). Thrombus formation on the device was detected in 12 cases (11 CardioSEALSTARflex, 1 Helex, 0 Amplatzer; P < 0.0001), of which 2 required surgery. Complete closure after single device implantation was more common with the Amplatzer and with the CardioSEAL-STARflex than with the Helex occluder: Amplatzer vs. Helex vs. CardioSEAL-STARflex: n = 217 (98.6%) vs. n = 202 (91.8%) vs. n = 213 (96.8%; P = 0.0012). Within 5 years of follow-up, the primary endpoint occurred in 25 patients (3.8%; 10 TIAs, 12 strokes and 3 cases of cerebral death). Compared with the CardioSEAL-STARflex (6%; 6 TIAs, 6 strokes, 1 cerebral death) and Helex groups (4%; 4 TIAs, 4 stroke, 1 cerebral death), significantly fewer events (P = 0.04) occurred in the Amplatzer group (1.4%; 2 strokes, 1 cerebral death). CONCLUSION Although procedural complications and long-term neurological event rates are low regardless of the device used, the recurrent neurological event rate was significantly lower after Amplatzer than after CardioSEAL-STARflex or Helex implantation. This has important implications regarding the interpretation of trials comparing PFO closure with medical management.
Patent foramen ovale transcatheter closure vs. medical therapy on recurrent vascular events: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND In patients with cryptogenic stroke, transcatheter (TC) closure of a patent foramen ovale (PFO) has not been shown to better prevent recurrent vascular events than medical therapy. However, randomized controlled trials (RCT) to date have included few vascular events, and lack of power has been raised as an important concern. OBJECTIVE To conduct a systematic review and meta-analysis of existing RCT published studies assessing the recurrence of vascular events after TC PFO closure when compared to medical therapy. METHODS Using the search terms "patent foramen ovale", "PFO", "stroke", "percutaneous closure" and "transcatheter closure", Medline, Pubmed, Embase, and Cochrane databases were reviewed from inception through April 2013, with no language restrictions. Only studies in adult humans were considered. Additional references were obtained from the bibliographies of studies reviewed. The following criteria were used for study selection: 1) randomized controlled trial, 2) subjects were adult patients with cryptogenic stroke who were randomized to TC PFO closure or medical treatment (antiplatelet therapy and/or anticoagulation), and 3) reported outcomes included cardiac death, all death, stroke, transient ischemic attack, and peripheral embolism. Methodological and descriptive data, adverse events (including raw data and risk estimates), as well as procedural success and complications were abstracted in duplicate from each study independently, and agreement was tested. We followed rigorously the recommended guidelines for reporting and conducting and assessing quality of meta-analysis of RCT. The primary endpoints pre-specified in advance were recurrent vascular events, and composite endpoint of death, and recurrent vascular events. RESULTS Three studies were identified as meeting selection criteria. These included a total of 2,303 patients, with 1,150 patients randomized to TC PFO closure and 1,153 patients randomized to medical therapy. Mean follow-up was 3.5 years. Baseline characteristics (age, sex, and cardiovascular risk factors) were similar across studies. Intention-to-treat analyses showed a statistically significant risk reduction in stroke and/or transient ischemic attack in the TC PFO closure group when compared to medical treatment, pooled HR = 0.59, 95%CI (0.36-0.97), P = 0.04. The combined outcome of death, and vascular events, showed a borderline statistically significant benefit for TC PFO closure when compared to medical treatment, pooled HR = 0.67, 95%CI (0.44-1.00), P = 0.05 Subjects with a substantial PFO shunt seem to benefit the most with TC PFO closure, pooled HR = 0.35, 95%CI (0.12-1.03), P = 0.06, however, it did not reach statistical significance. CONCLUSION These results suggest that in patients with cryptogenic stroke, TC PFO closure may be beneficial in reducing the risk of recurrent vascular events when compared to medical treatment. The benefit of TC PFO closure may be greater in patients with a substantial shunt.
Interventional radiology of the spine : image-guided pain therapy

I. Spinal Anatomy, Imaging, and Clinical Evaluation Spinal Anatomy Robert M. DePhilip and J. Kevin McGraw Computed Tomography of the Spine Stephen F. Futterer Magnetic Resonance Imaging of the Spine Eiran Mandelker, Gretchen G. Cordero, Dennis H. Son, and J. Kevin McGraw Nuclear Medicine of the Spine John E. Baumert, Jr. Clinical Evaluation of the Spine Patient L. Mark Dean II. Interventional Spinal Procedures History and Overview of Spinal Procedures J. Kevin McGraw Pharmacology of Medications Used in Spinal Injection Procedures John A. Lippert Selective Nerve Root Blocks Dennis J. Griffin Epidural Steroid Injections Dennis J. Griffin Facet Joint Injections Jeffrey M. Boorstein and J. Kevin McGraw Sacroiliac Joint Injections Jeffrey M. Boorstein and J. Kevin McGraw Discography John A. Carrino and J. Kevin McGraw Treatment of Discogenic Back Pain Jeff S. Silber, J. Kevin McGraw, and John A. Lippert Spinal Biopsy Techniques Thomas M. Davis Percutaneous Vertebroplasty David F. Kallmes, Mary E. Jensen, and J. Kevin McGraw Transcatheter Therapy for Tumors of the Spine Peter J. Pema and Ronald F. Budzik Index
Knitted bioclothes for cardiopulmonary monitoring

A new concept in healthcare, aimed to provide continuous remote monitoring of user vital signs, is emerging. An innovative system named WEALTHY is presented, where conducting and piezoresistive materials in form of fiber and yarn are integrated and used as sensor and electrode elements. The simultaneous recording of vital signs allows parameters' extrapolation and inter-signal elaboration that contribute to produce alert messages and synoptic patient table. The system will assist cardiac patients during rehabilitation, not only by caring physicians to have an accurate description of clinical status of the patient at fixed and repeated time points in order to tailor the best medical treatment for long term care, but will also allow the patient to be continuously followed during selected time intervals, such as during physical activity or occurrence of symptoms, to discover potential threats and generate appropriate alerts to patient, physician or emergency medical systems.
Sudden cardiac death in children (1-18 years): symptoms and causes of death in a nationwide setting.

AIMS Hitherto, sudden cardiac death in children (SCDc)-defined as sudden cardiac death (SCD) in the 1-18 years old-has been incompletely described in the general population. Knowledge on incidence rates, causes of death and symptoms prior to death is sparse and has been affected by reporting and referral bias. METHODS AND RESULTS In a nationwide setting all deaths in children aged 1-18 years in Denmark in 2000-06 were included. To chart causes of death and incidence rates, death certificates and autopsy reports were collected and read. By additional use of the extensive healthcare registries in Denmark, we were also able to investigate prior disease and symptoms. During the 7-year study period there was an average of 1.11 million persons aged 1-18 years. There were a total of 1504 deaths (214 deaths per year) from 7.78 million person-years. A total of 114 (7.5%) were sudden and unexpected. A cardiac disease was known prior to death in 18% of all sudden unexpected death cases. In two-thirds of all sudden unexpected death cases no previous medical history was registered. Causes of death in autopsied cases were cardiac or unknown in 70%. Unexplained deaths, presumed to be a primary cardiac arrhythmia, accounted for 28% of autopsied sudden unexpected death cases. Autopsy rate was 77%. There were a total of 87 cases of SCDc (5.8% of all deaths). Prodromal symptoms were noted in 26% and antecedent symptoms in 45% of SCDc cases. The most frequent antecedent symptoms were seizures, dyspnoea, and syncope. In total, 61% of SCDc were not known with any prior disease; 23% were known with congenital or other heart disease prior to death. In total, 43 (49%) of all sudden unexpected deaths died of a potential inherited cardiac disease. The incidence rate of sudden unexpected death was 1.5 per 100 000 person-years. The highest possible incidence rate of SCDc was 1.1 per 100 000 person-years. CONCLUSION From a nationwide study of all deaths in a 7-year period more than half of all victims of SCDc experienced antecedent and/or prodromal symptoms prior to death. The incidence rate of sudden death and SCDc was 1.5 and 1.1 per 100 000 person-years, respectively. Cardiac symptoms in young persons should warrant clinical work-up and an autopsy should be performed in all cases of sudden unexpected death in which the deceased was not known with congenital heart disease prior to death. This is pivotal, in the subsequent familial cascade screening, to diagnose and treat potential inherited cardiac diseases in family members.
Reporting of effect direction and size in abstracts of systematic reviews.

ered benign, does incur a risk for detrimental outcomes. Sarafidis also raises the issue of population-based dipstick screening. Our study was not designed to evaluate the cost-effectiveness or utility of such screening programs. Nevertheless, in the United States, about 10.8% of adults younger than 65 years have early-stage chronic kidney disease, and chronic kidney disease has been associated with disability even before the onset of ESRD, thus rendering undetected chronic kidney disease a public health concern. This, together with the fact that screening programs detect proteinuria in addition to hematuria, should be taken in account when considering the need for population-based screening. Even without population-based screening programs, urinary dipstick tests are commonly performed in young adults in different settings; the results of our study suggest that in such cases, the incidental finding of microscopic hematuria has diagnostic, follow-up, and management implications that should be further studied.
Colonoscopy screening compliance and outcomes in patients with Lynch syndrome

Colonic surveillance reduces the lifetime risk of colorectal cancer in patients with Lynch syndrome (hereditary nonpolyposis colorectal cancer) from 60 to 80% to 10% and confers a 7‐year survival advantage. The British Society of Gastroenterologists recommends colonoscopy at least every 2 years from the age of 25. Currently in the UK, genetic diagnosis is made by a regional genetics service, and screening recommendations are made to the referring clinician. The aim of this study was to investigate compliance with and the effectiveness of large bowel surveillance in Lynch syndrome.
Doppler‐guided transanal haemorrhoidal dearterialization for haemorrhoids: results from a multicentre trial

This multicentre study, based on the largest patient population ever published, aims to evaluate the efficacy of Doppler‐guided transanal haemorrhoidal dearterialization (THD Doppler) in the treatment of symptomatic haemorrhoids and to identify the factors predicting failure for an effective mid‐term outcome.
Narrow band imaging with magnification for the characterization of small and diminutive colonic polyps: pit pattern and vascular pattern intensity.

BACKGROUND AND STUDY AIMS Narrow band imaging (NBI) can accurately characterize colonic polyps using microvascular appearances. We aimed to assess whether the Kudo pit pattern classification is accurate when used with NBI (without dye-spray), and if microvascular appearances or NBI pit patterns maintain accuracy for polyp characterization at sizes < 10 mm. PATIENTS AND METHODS 116 polyps < 10 mm in size were detected in 62 patients undergoing surveillance colonoscopy. The polyps were prospectively assessed using NBI and magnification for Kudo pit pattern (III-V neoplastic, I-II non-neoplastic) and vascular pattern intensity (VPI), a measure of microvascular density (strong VPI, neoplastic; normal or weak VPI, non-neoplastic). Sensitivity, specificity, and accuracy were calculated and compared with results from histopathology. RESULTS The mean polyp size was 3.4 mm (range 1 - 9 mm). Overall, NBI pit pattern sensitivity, specificity, and accuracy were 0.88, 0.91, and 89.6 %, respectively. Equivalent values for VPI were 0.94, 0.89, and 91.4 %. Results were similar when polyps were subdivided into diminutive polyps (size <or= 5 mm) and flat polyps. Combining both pit pattern and VPI improved the sensitivity (0.98, P = 0.06 versus NBI pit pattern alone). There was very good agreement between NBI pit pattern and VPI for prediction of dysplasia (kappa = 0.83). No evidence of a learning curve for VPI was found. The NBI pit pattern was better than the VPI at subclassifying hyperplastic from other non-neoplastic polyps (sensitivity 0.79 versus 0.56, respectively, P = 0.02), but accuracy was poor. CONCLUSION The NBI pit pattern and VPI are both highly accurate in characterizing neoplastic colonic polyps of < 10 mm, with VPI appearing to be simple to learn. NBI has the potential to replace conventional histology for small polyps.
The experiences of caregivers looking after a child living with HIV and AIDS in rural Malawi

The aim of this study was to examine how caregivers manage their day-to-day living and health care needs, care for themselves and their sick children with HIV and AIDS in rural Malawi. The study used a longitudinal descriptive qualitative research design, using the “lens” of a narrative analysis theoretical framework to explore the experiences of caregivers looking after a child living with HIV and AIDS in rural Malawi. In-depth Interviews (IDIs) with women caregivers (n=20) recruited from Mponela Rural Hospital catchment area were conducted and all twenty women caregivers participated in in-depth interviews. Direct Observations (DOs) of the environment where interviews were conducted and at a local rural hospital were used to explore the primary care and support available for these women caregivers and their children. Data were analysed manually using the thematic analysis of the narrative accounts , combined with a detailed narrative analysis of one carers experiences to better understand how women constructed their stories in their own particular cultural context. A summary of the narrative analysis accounts of the rest of the 19 participants has been done to exemplify the main key issues each one of them had told in her story of caring for a child living with HIV and AIDS. R
ÜNİVERSİTE ÖĞRENCİLERİNİN CİNSİYET EŞİTLİĞİ TUTUMLARININ BELİRLENMESİ

Aim: The aim of this study is to determine the attitudes of university students about gender equality.Method: Population of this descriptive research includes students that have stayed in Erzurum general directorate of higher education credit and hostels institution in 2010-2011 academic years. Research sample is made of 507 volunteer students that were chosen with nonprobability sampling method. “Descriptive Information Form” and “Gender Equality Scale” were used inorder to gather data. In data evaluation process; average, standard deviation, percentage distributions, t-test in independent group and One Way Analysis of Variance were used.Results: Average age of the students that have attended the study was 21.64±1.93; %60.9 of students was female while %39.1 was male. %46.7 of students was graduated from high schools while %39.4 were studying in health sciences, %19.1 social sciences,, %29.4 educational sciences and %12 in physical sciences departments. Differences between Gender Equality Scale’s total point averages according to genders, high school programs from which students were graduated and departments at which they were studying were found to be statistically meaningful (p<0.005). Students’ Gender Equality Scale “Traditional Gender Norms” sub-scale average was 36.91±6.46, “Equalitarian Gender Norms” sub-scale point average was 8.61±2.24, and total point average was 45.53±6.71. Conclusion: It was determined that students that have attended the study had “medium-level” positive gender equality attitude. It was determined that female students who were graduated from Super High School/Anatolian High School andwho have been studying in health departments have more positive perceptions about gender equality.
Drug for severe sepsis is withdrawn from market, fails to reduce mortality.

A DRUG ONCE BELIEVED TO IMprove mortality rates of patients with severe sepsis has been withdrawn from the market because new evidence has revealed it fails to do so—10 years after the drug was approved by the US Food and Drug Administration (FDA). Eli Lilly and Company announced on October 25 that it was withdrawing drotrecogin alfa (activated) [Xigris, a recombinant human activated protein C (rhAPC)]. The withdrawal marks the end of a checkered history for rhAPC that began while the drug was initially under review during the FDA’s approval process. At that time, an advisory committee for the agency rendered a split vote on whether to recommend approval. This ambivalence prompted the agency to limit the indication for the drug to adult patients with severe sepsis (sepsis associated with acute organ dysfunction) who were at high risk of death. Even with the restriction, the drug—the only agent thought to reduce mortality in patients with severe sepsis—has been estimated to have generated more than $1 billion in sales in the decade it remained on the market. The FDA’s counterpart in Europe, the European Medicines Agency (EMA), has also been ambivalent about rhAPC. The EMA approved the drug in 2002, but by 2007, its Committee for Medicinal Products for Human Use (CHMP) noted that the initial efficacy results of the trial that served as the basis for the drug’s approval—the Recombinant Human Activated Protein C Worldwide Evaluation in Severe Sepsis (PROWESS) study (Bernard GR et al. N Engl J Med. 2001;344[10]:699-709)—had not been replicated in further studies. At the CHMP’s request, Lilly agreed to conduct a new placebo-controlled study to confirm that the benefits of rhAPC outweighed its risks in patients with septic shock—the latter being an indication similar but not identical to severe sepsis with multiple organ failure.
Student Retention and the course choice process: the UK Open University experience

There is evidence that a student's initial choice of course is an important influence on their subsequent success and retention. This article argues that course descriptions on their own are an inadequate guide to the choice of appropriate course and that in mass higher education individual guidance will be costly to institutions. Other methods of course-choice advice delivery are needed, such as preview materials, students' comments on courses and diagnostic materials. The article reviews the UKOU's experience of these methods and suggests that not only do they promote more accurate course choice but that they also enhance students' confidence in their choice. The article also argues that there can be considerable positive financial return on investment to institutions in the use of such materials.
Is there a Care Gap for Young Carers in Canada? Edmonton Community Agencies’ Perspectives

This paper presents the findings of a study exploring the perspectives of community agencies in Edmonton, Alberta on issues related to young carers (young people who are primary caregivers to a family member or friend who is ill, disabled, or has other conditions needing care or support). Four themes emerged from the qualitative research: lack or awareness and recognition of young carers; language and terminology used to label young carers; lack of community support; and the need for policy development relevant to young carers. The study draws attention to a group of young people who remain hidden and unrecognized in Canadian society.
Mechanisms of the Action of Zoledronic Acid on Human MG-63 Osteosarcoma Cells

The aim of our study was to analyze the action of zoledronic acid on MG-63 human osteosarcoma cells. The proliferation of MG-63 cells was inhibited by either continuous or pulsatile exposures of zoledronic acid in a dose-dependent manner (10-250 microM). Zoledronic acid did not produce evidence of MG-63 cell death when administered at 100 mM for 48 hours, but only after exposure of 96 hours. Zoledronic acid (100 microM) increased the distribution of MG-63 cells in G0/G1 phase, however, it did not increase the adriamycin-induced apoptosis. In addition, zoledronic acid action was partially neutralized by exogenous administration of geranylgeranyl pyrophosphate (GGPP), but not by farnesyl pyrophosphate (FPP). Furthermore, zoledronic acid resulted in the attenuation of the prenylated form of Ras. Zoledronic acid and EDTA increased fluorescence of Fluo-3 loaded MG-63 cells in a similar pattern. This increase was owing to the release of Ca2+ from intracellular stores since zoledronic acid failed to reveal such a change to intracellular Ca2+ when cells were previously treated with 1 mM caffeine. Moreover, zoledronic acid significantly decreased the expression of estrogen receptor alpha (ERalpha) whereas it did not change significantly the expression of estrogen receptor beta (ERbeta) in MG-63 cells. These data suggest that zoledronic acid can control the proliferation and the differentiation of osteosarcoma-like cells.