Miracle-dz/UniFAR-FTUs huggingface dataset:
Cancer-related deaths in children and adolescents.

BACKGROUND To add to the data regarding the quality of care given to dying children and their families. OBJECTIVE To develop baseline of end-of-life care at a single pediatric facility to evaluate institution-wide palliative care initiative. DESIGN Retrospective chart review of all known deaths during an 18-month time period. SETTING/SUBJECTS One hundred forty-five charts of patients from a single pediatric cancer facility who died during designated time period. MEASUREMENTS Variables included: cause and place of death; CPR/DNR status prior to death; length of end of life care prior to death; sibling counseling and bereavement counseling offered to family after death; and wishes or preferences of patient/family regarding the death experience. RESULTS Results included: solid tumor patients more likely to die of progressive disease than leukemia or bone marrow transplant patients; bone marrow transplant patients 2-3 times more likely to die of cardiopulmonary or cardiovascular complications; solid tumor patients were more likely to die at home than leukemia patients; solid tumor/brain tumor patients had a median time in end of life or palliative care of 29 days compared to leukemia patients' median of 11 days; 48% of DNRs completed 11 days prior to death. CONCLUSIONS Relationship exists between diagnosis, cause and place of death in this population; findings replicate findings of 4 similar studies; accurate and consistent quality standards of care need to be established for this population as well as methods of documentation before reviewing/accrediting agencies impose standards that are not evidence based.
Permolybdate and pertungstate--potent stimulators of insulin effects in rat adipocytes: mechanism of action.

In previous studies, tungstate and molybdate were found to mimic the biological actions of insulin. It was suggested that these metallooxides initially inhibit vanadate-sensitive protein phosphotyrosine phosphatase (PTPase). This, in turn, stimulates a staurosporine-sensitive cytosolic protein tyrosine kinase (cytPTK), which activates several insulin bioeffects via insulin-independent pathways (Shisheva & Shechter, 1991, 1993; Elberg et al., 1994). Tungstate and molybdate, however, facilitate bioeffects in rat adipocytes only at high (millimolar) concentrations (Goto et al., 1992). We report here that incubations of tungstate or molybdate with hydrogen peroxide (H2O2) result in the formation of pertungstate (pW, peroxide of tungstate) or permolybdate (pMo, peroxide of molybdate). Pertungstate and permolybdate were found to stimulate all or most of the insulin bioeffects in rat adipocytes. Moreover, these permetallooxides are 80-180-fold more potent stimulators than the corresponding metallooxides. This shift in potency resembles that of pervanadate relative to vanadate in stimulating the same effect in rat adipocytes (Fantus et al., 1989). pW and pMo are also active in normalizing blood glucose levels in streptozotocin-induced diabetic rats. Further studies aimed at understanding the higher efficacy of this permetallooxide revealed the following: (a) All three permetallooxides (pV, pW, pMo) are oxidizing agents relative to reduced glutathione (GSH). They oxidize stoichiometric amounts of GSH to GSSG. (b) All three metallooxides do not oxidize GSH to GSSG. (c) Both metallooxides and permetallooxides inhibit rat adipocytic PTPase at micromolar quantities (IC50 = 3-10 microM). Permetallooxides, however, inhibited a larger PTPase fraction (80-100%) compared to metallooxides (40-70% of the total). (ABSTRACT TRUNCATED AT 250 WORDS)
Gastrointestinal symptoms in patients undergoing peritoneal dialysis: multivariate analysis of correlated factors.

AIM To investigate gastrointestinal (GI) symptoms in peritoneal dialysis (PD) patients and to explore related factors contributing to GI symptoms. METHODS One hundred and twelve patients undergoing PD participated in the study. The gastrointestinal symptom rating scale was used for measuring GI symptoms. Information on age, height, weight, body mass index, disease leading to chronic renal failure, history of corticosteroid therapy, presence of predialytic GI symptoms, daily dosage of pills, and duration, type and daily dialysate volume of PD was obtained by interviewing patients and/or reviewing the medical records. Hemoglobin, albumin and Kt/V data were obtained from follow-up database. We used multiple regression analysis with stepwise backward variable selection to test for factors predicting GSRS scores with significance level of selection entry at 0.05 and selection of stay at 0.10. RESULTS The prevalence of eating dysfunction, reflux and indigestion in the PD patients was 44.2%, 32.7%, 32.7%, respectively. A history of corticosteroid therapy (b = 8.93, P < 0.001) and all pills daily intake (b = 0.16, P = 0.007) were positively correlated to GI symptoms, while residual renal Kt/V (b = -3.47, P = 0.009) was negatively correlated to GI symptoms. Other factors were proven to be not associated with GI symptoms, with P > 0.05. CONCLUSION Eating dysfunction, reflux and indigestion were common in PD patients. Daily dosage of pills and corticosteroid history predicted GI symptoms, while residual renal function prevented them.
Posttraumatic olfactory dysfunction: MR and clinical evaluation.

PURPOSE To evaluate the sites of injury in patients with posttraumatic olfactory deficits and to compare damage with findings on clinical olfactory tests. METHODS Twenty-five patients with posttraumatic olfactory dysfunction were examined by means of olfactory testing, endoscopy, and MR imaging. MR surface-coil scans through the olfactory bulbs and tracts and head-coil scans of the temporal lobes were evaluated. Quantitative and qualitative gradings of damage to the olfactory bulbs, tracts, subfrontal region, hippocampus, and temporal lobes were compared with results on tests of odor identification, detection, memory, and discrimination. RESULTS Twelve patients were anosmic, eight had severe impairment, and five were mildly impaired. Injuries to the olfactory bulbs and tracts (88% of patients), subfrontal region (60%), and temporal lobes (32%) were found, but these did not correlate well with individual olfactory test scores. Volumetric analysis showed that patients without smell function had greater volume loss in olfactory bulbs and tracts than did those posttraumatic patients who retained some sense of smell. Qualitative and quantitative assessments of damage showed few significant correlations with olfactory tests, probably because of multifocal injuries, primary olfactory nerve damage, and the constraints of a small sample size on the detection of clinically significant differences. CONCLUSION MR imaging shows abnormalities in patients with posttraumatic olfactory dysfunction at a very high rate (88%), predominantly in the olfactory bulbs and tracts and the inferior frontal lobes.
Initial Experience with Nab-Paclitaxel for Patients with Advanced Gastric Cancer: Safety and Efficacy.

BACKGROUND Taxane-based chemotherapy is useful for peritoneal dissemination control in advanced/recurrent gastric cancer; however, insufficient relative dose intensity (RDI) may preclude disease control achievement. Nab-paclitaxel, with high tumour permeability, is a promising second- or later-line treatment. PATIENTS AND METHODS We retrospectively evaluated the clinical safety and efficacy of nab-paclitaxel for advanced/recurrent gastric cancer patients treated between April 2013 and December 2015. The response rate, RDI and survival outcomes were assessed. RESULTS Of 14 evaluated patients, 4 achieved partial response. Overall response and the disease control rates were 28.5% and 64.2%, respectively. Nine patients developed peritoneal metastasis; their overall response and disease control rate were 22.2% and 66.6%. Patients with high RDI (≥80%) showed longer progression-free and overall survival than those with low RDI (≤80%) (11.8 vs. 4.0 months, p=0.02; and 14.3 vs. 8.2 months, p=0.03, respectively). CONCLUSION Nab-paclitaxel, at an RDI ≥80%, was safe and beneficial for these patients.
TOPIC HIGHLIGHT

Psychological stress is an important factor for the development of irritable bowel syndrome (IBS). More and more clinical and experimental evidence showed that IBS is a combination of irritable bowel and irritable brain. In the present review we discuss the potential role of psychological stress in the pathogenesis of IBS and provide comprehensive approaches in clinical treatment. Evidence from clinical and experimental studies showed that psychological stresses have marked impact on intestinal sensitivity, motility, secretion and permeability, and the underlying mechanism has a close correlation with mucosal immune activation, alterations in central nervous system, peripheral neurons and gastrointestinal microbiota. Stress-induced alterations in neuro-endocrine-immune pathways acts on the gut-brain axis and microbiota-gut-brain axis, and cause symptom flare-ups or exaggeration in IBS. IBS is a stresssensitive disorder, therefore, the treatment of IBS should focus on managing stress and stress-induced responses. Now, non-pharmacological approaches and pharmacological strategies that target on stress-related alterations, such as antidepressants, antipsychotics, miscellaneous agents, 5-HT synthesis inhibitors, selective 5-HT reuptake inhibitors, and specific 5-HT receptor antagonists or agonists have shown a critical role in IBS management. A integrative approach for IBS management is a necessary. © 2014 Baishideng Publishing Group Inc. All rights reserved.
The effects of biaxially-tensile strain to properties of Si/SiO2 interface states generated by electrical stress

In this paper, the effects of biaxially-tensile strain on the properties of Si/SiO<sub>2</sub> interface states generated by FN stress have been systematically investigated. In order to accurately evaluate interface state density (D<sub>it</sub>) in MOS capacitors and FETs including strained-Si (sSi)/SiGe hetero-interfaces, the conductance method and the S-factor method have been properly modified. It is found that strain does not strongly change the properties of SiO<sub>2</sub>/Si interface states. On the other hand, almost similar ΔD<sub>it</sub> and smaller ΔV<sub>th</sub> is observed in sSi n-MOSFETs after FN stress. These inconsistent behaviors between ΔD<sub>it</sub> and ΔV<sub>th</sub> can be explained by the relative shift of the charge neutrality level inside the band gap of strained Si.
The role of quality improvement initiatives in healthcare operational environments: changes, challenges and responses.

PURPOSE The purpose of this paper is to shed some light on the utilization of quality improvement initiatives in healthcare operational environments. In the process, environmental changes and strategic responses are examined for a sample of healthcare organizations. DESIGN/METHODOLOGY/APPROACH A survey-based research methodology is utilized in this study. Factor analysis is used to extract relevant factors representing environmental changes and strategic options relevant to healthcare organizations. In addition, simple percentages are utilized to assess the extent of implementation and effectiveness of quality improvement initiatives. FINDINGS In general, the findings appear to indicate that the studied organizations have achieved both operational and strategic benefits due to the effective implementation of quality improvement initiatives. The implementation of quality improvement initiatives appears to be in response to environmental changes and challenges faced by healthcare organizations. PRACTICAL IMPLICATIONS Based on the findings of this study, decision-makers are encouraged to commit organizational resources toward the effective implementation of quality improvement initiatives. Investing in quality improvement not only is justified, but also appears to be very much needed in a changing competitive environment. ORIGINALITY/VALUE This study contributes to enhancing one's practical and theoretical understanding of the competitive impact of quality improvement initiatives in different operational settings.
Clostridium difficile toxin B inhibits carbachol‐induced force and myosin light chain phosphorylation in guinea‐pig smooth muscle: role of Rho proteins

1 Clostridium difficiletoxin B glucosylates the Ras‐related low molecular mass GTPases of the Rho subfamily thereby inactivating them. In the present report, toxin B was applied as a tool to test whether Rho proteins participate in the carbachol‐induced increase in the Ca2+ sensitivity of force and myosin light chain (MLC) phosphorylation in intactintestinal smooth muscle. 2 Small strips of the longitudinal muscle of guinea‐pig small intestine were incubated in toxin B (40 ng ml−1) overnight. Carbachol‐induced force and intracellular [Ca2+], and, in a separate series, force and MLC phosphorylation, were determined. 3 Carbachol induced a biphasic contraction: an initial rapid increase in force (peak 1) followed by a partial relaxation and a second delayed increase in force (peak 2). The peak of the Ca2+ signal measured with fura‐2 preceded peak 1 of force and then declined to a lower suprabasal steady‐state level. Peak 2 was not associated with a significant increase in [Ca2+]. Toxin B nearly completely inhibited peak 2 while peak 1 was not significantly inhibited. Toxin B had no effect on the Ca2+ transient. 4 In control strips, MLC phosphorylation at peak 2 was 27.7 %, which was significantly higher than the resting value (18.6 %). The inhibition of the second, delayed, rise in force induced by toxin B was associated with complete inhibition of the increase in MLC phosphorylation. The resting MLC phosphorylation was not significantly different from that of the control strips. 5 The initial increase in MLC phosphorylation determined 3 s after exposure to carbachol was 54 % in the control strips. Toxin B also inhibited this initial phosphorylation peak despite the fact that the Ca2+ transient and the initial increase in force were not inhibited by toxin B. This suggests that Rho proteins play an important role in setting the balance between MLC phosphorylation and dephosphorylation reactions even at high levels of intracellular Ca2+. 6 These findings are consistent with the hypothesis that the delayed rise in force elicited by carbachol is due to an increase in the Ca2+ sensitivity of MLC phosphorylation mediated by Rho proteins.
Sulforaphane protection against the development of doxorubicin‐induced chronic heart failure is associated with Nrf2 Upregulation

BACKGROUND Doxorubicin (DOX) is an anthracycline antitumor drug. However, its clinical use is limited by dose-dependent cardiotoxicity and even progresses to chronic heart failure (CHF). OBJECTIVE This study aims to investigate whether the Nrf2 activator, sulforaphane (SFN), can prevent DOX-induced CHF. METHODS Male Sprague-Dawley rats which received treatment for 6 weeks were divided into four groups (n=30 per group): control, SFN, DOX and DOX plus SFN group. RESULTS Results revealed that DOX induced progressive cardiac damage as indicated by increased cardiac injury markers, cardiac inflammation, fibrosis and oxidative stress. SFN significantly prevented DOX-induced progressive cardiac dysfunction between 2-6 weeks and prevented DOX-induced cardiac function deterioration. Furthermore, it significantly decreased ejection fraction and increased the expression of brain natriuretic peptide. SFN also almost completely prevented DOX-induced cardiac oxidative stress, inflammation and fibrosis. SFN upregulated NF-E2-related factor 2 (Nrf2) expression and transcription activity, which was reflected by the increased mRNA expression of Nrf2 and its downstream genes. Furthermore, in cultured H9c2 cardiomyocytes, the protective effect of SFN against DOX-induced fibrotic and inflammatory responses was abolished by Nrf2 silencing. CONCLUSION We arrived at the conclusion that DOX-induced CHF can be prevented by SFN through the upregulation of Nrf2 expression and transcriptional function.
Role of NF-E2 related factor 2 (Nrf2) on chemotherapy resistance in acute myeloid leukemia (AML) and the effect of pharmacological inhibition of Nrf2

Cytarabine (Ara-C) and Daunorubicin (Dnr) forms the backbone of acute myeloid leukemia (AML) therapy. Drug resistance and toxic side effects pose a major threat to treatment success and hence alternate less toxic therapies are warranted. NF-E2 related factor-2 (Nrf2), a master regulator of antioxidant response is implicated in chemoresistance in solid tumors. However, little is known about the role of Nrf2 in AML chemoresistance and the effect of pharmacological inhibitor brusatol in modulating this resistance. Primary AML samples with high ex-vivo IC50 to Ara-C, ATO, Dnr had significantly high NRF2 RNA expression. Gene-specific knockdown of NRF2 improved sensitivity to these drugs in resistant AML cell lines by decreasing the expression of downstream antioxidant targets of Nrf2 by compromising the cell’s ability to scavenge the ROS. Treatment with brusatol, a pharmacological inhibitor of Nrf2, improved sensitivity to Ara-C, ATO, and Dnr and reduced colony formation capacity. AML cell lines stably overexpressing NRF2 showed increased resistance to ATO, Dnr and Ara-C and increased expression of downstream targets. This study demonstrates that Nrf2 could be an ideal druggable target in AML, more so to the drugs that function through ROS, suggesting the possibility of using Nrf2 inhibitors in combination with chemotherapeutic agents to modulate drug resistance in AML.
Arthroscopically Assisted Semitendinosus and Gracilis Tendon Graft in Reconstruction for Acute Anterior Cruciate Ligament Injuries in Athletes

We evaluated 69 arthroscopically assisted anterior cru ciate ligament reconstructions for acute tears at an average followup of 60 months. We used a distally based single semitendinosus and gracilis tendon graft passed over the top and fixed to the femur. Combined medial collateral ligament lesions were seen in 30 knees, and they were repaired when found in the distal third (18 knees). The patients were instructed to re cover motion preoperatively, and an early range of motion program was used postoperatively. At followup, symptoms of giving way were seen in five knees (7%). Graft failure was seen in seven knees (10%); failure was defined as a positive pivot shift (clunk or gross) or a side-to-side difference in anterior tibial displacement greater than 5 mm, as measured with a KT-1000 ar thrometer. Permanent extension loss (3° to 5°) was found in two knees (3%). Patellofemoral crepitation was seen in eight knees (12%), but the condition was symptomatic in only one knee. Forty-six patients (67%) were active in pivoting sports before surgery and 37 (54%) remained active in these sports at followup. We concluded that this operation is simple, effective, and has a low complication rate. Further studies are nec essary to elucidate if a stronger graft (e.g., a patellar tendon) would decrease the rate of graft failure without increasing complications.
The effects of verbal support strategies on small-group peer interactions.

PURPOSE This study investigated whether child care providers could learn to facilitate peer interactions by using verbal support strategies (e.g., prompts, invitations, or suggestions to interact) during naturalistic play activities. METHOD Seventeen caregivers were randomly assigned to experimental and control groups, stratified by center so that staff from one center could attend the training program together. The experimental group received inservice training on how to facilitate peer interaction; the control group received training on adult-child communication strategies. Caregivers in the experimental group were taught to facilitate children's interactions with their peers by using indirect referrals (e.g., alerting children to situational information, offering praise) and direct referrals (e.g., telling a child what to say to a peer, inviting children to play together). RESULTS At posttest, the caregivers in the experimental group used more verbal supports for peer interaction than the caregivers in the control group. Specifically, they used more utterances to promote communication between peers and to invite children to interact together. In turn, the children in the experimental group initiated interactions with peers more often and engaged in extended peer sequences more often than the children in the control group. CLINICAL IMPLICATIONS The results support the viability of this training model in early childhood education settings and suggest that future research of its effects with children who have disabilities is warranted.
Relationship between Vision and Visual Perception in Hong Kong Preschoolers

Purpose Although superior performance in visual motor and visual perceptual skills of preschool children has been documented in the Chinese population, a normative database is only available for the US population. This study aimed to determine the normative values for these visuomotor and visual perceptual tests for preschool children in the Hong Kong Chinese population and to investigate the effect of fundamental visual functions on visuomotor and visual perceptual skills. Methods One hundred seventy-four children from six different kindergartens in Hong Kong were recruited. Distance visual acuity, near visual acuity, and stereopsis were tested, along with two measures of visual perception (VP): Visual-Motor Integration (VMI) and Test of Visual-Perceptual Skills (TVPS). Raw VMI and TVPS scores were converted into standard/scaled scores. The impact of basic visual functions on VP (VMI and TVPS) was examined using multiple regression. Results Visual functions were generally good: only 9.2 and 4.6% of subjects had unilateral and bilateral reduced habitual vision, respectively (distance visual acuity in the better eye >0.3 logMAR [logarithm of the minimum angle of resolution]). Performance in the VMI and in the visual memory and spatial relationships subtests of the TVPS exceeded that reported for age-matched children from the United States. Multiple regression analysis provided evidence that age had the strongest predictive value for the VMI and VP skills. In addition, near visual acuity was weakly associated with performance in the VMI and the visual discrimination and spatial relationships subtests of the TVPS, accounting for a limited proportion of the intersubject variability (R2 < 3%; p < 0.001). Conclusions Hong Kong preschoolers outperformed their US peers in the VMI and visual memory/spatial relationships of TVPS subtests, perhaps attributed to greater exposure to such material during their preschool home education. This study provided normality data for VMI and four subtests of the TVPS for Hong Kong Chinese preschool children as a reference for future studies.