Miracle-dz/UniFAR-FTUs huggingface dataset:
A randomized controlled trial of four precolonoscopy bowel cleansing regimens.

BACKGROUND The ideal bowel cleansing regimen for colonoscopy has yet to be determined. OBJECTIVE To compare the cleansing efficacy, and patient tolerability and safety of four bowel preparation regimens. METHODS A total of 834 patients undergoing outpatient colonoscopy were randomly assigned to one of four regimens: 4 L polyethylene glycol (PEG); 2 L PEG + 20 mg bisacodyl; 90 mL of sodium phosphate (NaP); or two sachets of a commercially available bowel cleansing solution (PSMC) + 300 mL of magnesium citrate (M). The primary outcome measure was cleansing efficacy, which was scored by blinded endoscopists using the Ottawa Bowel Preparation Scale. Secondary outcome measures were bowel preparation quality according to time of colonoscopy, and patient tolerability and safety. RESULTS The mean total cleansing score was significantly worse in the NaP group compared with the other three groups (P<0.0001). The mean cleansing scores were worse in patients who underwent morning versus afternoon colonoscopy, a finding that was consistent in all four groups. PSMC + M was the best tolerated regimen. No clinically significant mean changes in creatinine or electrolyte levels were identified, although a significantly higher proportion of patients in the NaP group developed hypokelemia (P<0.0001). CONCLUSIONS 2 L PEG + 20 mg bisacodyl, or PSMC + M was as efficacious as 4 L PEG and superior to NaP for bowel cleansing. A short interval between the completion of bowel preparation and the start of colonoscopy (ie, 'runway time'), irrespective of bowel preparation regimen, appeared to be a more important predictor of bowel cleanliness than the cathartic agents used.
Pain, depression levels, fatigue, sleep quality, and quality of life in elderly patients with rheumatoid arthritis.

BACKGROUND/AIM The aim of this study was to evaluate and determine the relationships (if any) among pain, depression levels, fatigue, sleep quality, and quality of life in patients with rheumatoid arthritis (RA) aged 65 years and over, and to compare the results with those of RA patients under 65 years of age. MATERIALS AND METHODS The study included 52 patients with RA aged 65 years and over (Group 1) and 84 patients with RA under 65 years of age (Group 2). Pain, depression levels, fatigue, sleep quality, quality of life, and disease activity of all of the participants were evaluated using a visual analog scale (VAS), the Beck Depression Inventory (BDI), the Checklist Individual Strength (CIS), the Pittsburgh Sleep Quality Index (PSQI), the Short Form-36 (SF-36), and the Disease Activity Score-28, respectively. RESULTS When the two groups were compared, higher scores for the VAS, BDI, total CIS, and PSQI were found in Group 1 compared to Group 2 (P = 0.003, P = 0.003, P = 0.007, and P = 0.001, respectively). The SF-36 subscales of the physical component summary and mental component summary were not statistically significantly different between the two groups (P > 0.05). CONCLUSION This study evaluated the situation in elderly patients with RA and showed that pain, depression level, fatigue, and sleep quality worsen with age.
Executive Leadership Challenges Implementing Systemic Change Under Conditions of Litigated Reform

ABSTRACT A case study was conducted using the lens of second-order change to examine leadership challenges during litigated-based reform of New Jersey’s child welfare agency. Six challenges identified included (a) difficulty implementing the comprehensive reform plan; (b) attempting systemwide change within a weak infrastructure; (c) leadership instability; (d) unclear leader roles and responsibilities; (e) poor diffusion of the case practice model, and (f) weak quality control mechanisms. Three recommendations for reducing implementation failures included developing rich pictures to understand system interdependencies, using open communication to facilitate change readiness, and implementing a sustainable quality review system to guide the change process.
Palmar dislocation of scaphoid and lunate

A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.
Retreatment With Teriparatide One Year After the First Teriparatide Course in Patients on Continued Long‐Term Alendronate

Patients treated with teriparatide after prior and ongoing alendronate therapy experience spine BMD increases; however, some continue to be at high risk for fracture, based on persistently low BMD and/or fracture history. The objective of this study was to determine whether a second discrete retreatment course with teriparatide could produce similar biochemical and BMD changes as seen during the first teriparatide course. In the original treatment study, 126 women on alendronate for ≥1 yr were randomized to continue alendronate and receive daily teriparatide, cyclic teriparatide (3‐mo cycles), or alendronate alone for 15 mo. Of the 72 patients who completed either original teriparatide regimen, 49 completed a 12‐mo follow‐up on continued alendronate alone. At that time, 32 patients, who remained at high risk of future fracture, were recruited into the retreatment protocol and 27 completed another course of teriparatide administered daily for 15 mo (including 15 from the original daily treatment group and 12 from the original cyclic treatment group). Bone formation indices (propeptide of type I procollagen and osteocalcin) increased during both teriparatide courses with median 3‐mo increments of 120% and 72% above baseline during the original course and 60% and 40% above baseline during retreatment, respectively. Mean spine BMD increments were 6.2% after the first daily course and 4.7% after retreatment and 4.1% after the first course of cyclic teriparatide and 4.9% after retreatment. We conclude that retreatment with teriparatide stimulates bone formation and increases spine BMD to a similar extent as seen during the original teriparatide course. Retreatment with teriparatide may be a viable option for some patients with severe osteoporosis who have received prior teriparatide therapy.
Longitudinal evaluation of the metabolic response of a tumor xenograft model to single fraction radiation therapy using magnetic resonance spectroscopy

Proton magnetic resonance spectroscopy (MRS) was used to evaluate the metabolic profile of human glioblastoma multiform brain tumors grown as xenografts in nude mice before, and at multiple time points after single fraction radiation therapy. Tumors were grown over the thigh in 16 mice in this study, of which 5 served as untreated controls and 11 had their tumors treated to 800 cGy with 200 kVp x-rays. Spectra were acquired within 24 h pre-treatment, and then at 3, 7 and 14 d post-treatment using a 9.4 T animal magnetic resonance (MR) system. For the untreated control tumors, spectra (1–2 per mouse) were acquired at different stages of tumor growth. Spectra were obtained with the PRESS pulse sequence using a 3 × 3 × 3 mm3 voxel. Analysis was performed with the LCModel software platform. Six metabolites were profiled for this analysis: alanine (Ala), myo-inositol (Ins), taurine (Tau), creatine and phosphocreatine (Cr + PCr), glutamine and glutamate (Glu + Gln), and total choline (glycerophosphocholine + phosphocholine) (GPC + PCh). For the treated cohort, most metabolite/water concentration ratios were found to decrease in the short term at 3 and 7 d post-treatment, followed by an increase at 14 d post-treatment toward pre-treatment values. The lowest concentrations were observed at 7 d post-treatment, with magnitudes (relative to pre-treatment concentration ratios) of: 0.42 ± 24.6% (Ala), 0.43 ± 15.3% (Ins), 0.68 ± 27.9% (Tau), 0.52 ± 14.6% (GPC+PCh), 0.49 ± 21.0% (Cr + PCr) and 0.78 ± 24.5% (Glu + Gln). Control animals did not demonstrate any significant correlation between tumor volume and metabolite concentration, indicating that the observed kinetics were the result of the therapeutic intervention. We have demonstrated the feasibility of using MRS to follow multiple metabolic markers over time for the purpose of evaluating therapeutic response of tumors to radiation therapy. This study provides supporting evidence that metabolite/water concentration ratios have the potential to be used as biomarkers for the assessment of the response to therapy.
Complaining About Others at Work

ABSTRACT The article investigates the interactional work required to launch a complaint about nonpresent third parties in discussions between employees and their manager. The study shows how the complaint recipient (the manager) creates opportunities for the complainer (the employee) to complain, and how the recipient and complainer collaboratively facilitate entry into complaining by means of building joint epistemic access and affective stance toward the complainable. Focusing on the institutional context of performance appraisal interviews, the study further indicates that the legitimation of complaining is collaboratively treated as a managerial task. Data are in Finnish and Danish with English translation.
B7-H3 promoted proliferation of mouse spermatogonial stem cells via the PI3K signaling pathway

Objective We found seminal B7-H3 was associated with human sperm concentration. However, the mechanism is unclear. The purpose of this study was to investigate the expression of B7-H3 in mouse testis and determine the effects of B7-H3 on the proliferation of mouse spermatogonial stem cells (SSCs) and the underlying mechanisms. Methods B7-H3 expression in the testis of mice at different ages (3 weeks, 8 weeks, 4 months and 9 months) was detected by western blot and immunohistochemistry. CCK-8 were used to measure mouse SSCs proliferation after incubation with different concentrations of B7-H3 for 1-72 h in vitro. Flow cytometry was used to analyze the cell cycle of mouse SSCs after incubation with different concentrations of B7-H3 for 48 and 72 h. The signaling pathways involved were assessed by western blot. Results Four-month-old mice had the highest expression of B7-H3 in the testis, while 3-week-old mice had the lowest expression of B7-H3. B7-H3 was predominantly detected on the membrane and in the cytoplasm of Sertoli cells. Furthermore, B7-H3 promoted mouse SSCs proliferation and increased the percentage of cells in S+G2/M phase in a time- and dose-dependent manner in vitro. These effects were inhibited by LY294002, indicating the involvement of the phosphoinositide 3-kinase signaling pathway. Conclusions The expression of B7-H3 in mouse testis, especially Sertoli cells, was associated with mouse age. In vitro, B7-H3 promoted the proliferation and accelerated the cell cycle of mouse SSCs via the PI3K pathway, indicating a critical role of B7-H3 expressed by Sertoli cells in mouse spermatogenesis.
Does HIV VCT reduce risk behaviors? An observational study in Guatemala City.

OBJECTIVE We examined the impact of HIV voluntary counseling and testing on self-reported behavioral risks three months after HIV testing. DESIGN Cohort study comparing self-reported risk behaviors prior to and three months after HIV testing. SETTING Clinica Familiar Luis Angel Garcia, an HIV specialty clinic located in a Guatemalan National Hospital. SUBJECTS, PARTICIPANTS 144 people undergoing HIV testing were enrolled. 44 were HIV positive. 41 HIV positive and 49 HIV negative subjects returned for follow-up interviews. INTERVENTION All subjects were tested and received voluntary counseling regarding HIV infection, transmission, prevention, and interpretation of HIV test results. MAIN OUTCOME MEASURE The primary study outcome measure was change in self-reported risk behaviors three months after voluntary counseling and testing. RESULTS Men were more likely than women to report a history of sexually transmitted diseases, more than 2 sexual partners, using alcohol with sex, and receiving money for sex; they were less likely to have a regular partner. 26% of men reported non-heterosexual orientation; no woman did. Alcohol was the primary drug of abuse in both men and women. At three month follow-up HIV positive subjects showed decreases in the average number of sexual partners, use of alcohol with sex, and episodes of unprotected sex. CONCLUSIONS Voluntary counseling and testing resulted in changes in some self-reported risk behaviors, but only among HIV positive subjects. On nearly all measures men report riskier behavior than women. Alcohol is the most commonly used drug in this population and is often used with sex.
PRICE SPREADS IN CUT-FLOWER MARKETING: SOME EVIDENCE FROM BANGLADESH

Flower marketing has been expanding rapidly but in an unorganized way. The present study has examined the existing marketing system, estimated marketing cost, margins of different flowers of different marketing channels. Flower growers received 30.75% to 60.42% of the consumer's taka while 24.71% to 58.5% were spent as the marketing cost. The net marketing margin varied from 3.0% to 37.83% of consumer's taka. Growers used channel I most though it involved highest cost of all the channels. Adoption of proper measures for the solution of the current problems would improve the efficiency of the marketing system which will in turn increase grower's share in consumer's taka.
Akt Forms an Intracellular Complex with Heat Shock Protein 90 (Hsp90) and Cdc37 and Is Destabilized by Inhibitors of Hsp90 Function*

Hsp90 is a chaperone required for the conformational maturation of certain signaling proteins including Raf, cdk4, and steroid receptors. Natural products and synthetic small molecules that bind to the ATP-binding pocket in the amino-terminal domain of Hsp90 inhibit its function and cause the degradation of these client proteins. Inhibition of Hsp90 function in cells causes down-regulation of an Akt kinase-dependent pathway required for D-cyclin expression and retinoblastoma protein-dependent G1 arrest. Intracellular Akt is associated with Hsp90 and Cdc37 in a complex in which Akt kinase is active and regulated by phosphatidylinositol 3-kinase. Functional Hsp90 is required for the stability of Akt in the complex. Occupancy of the ATP-binding pocket by inhibitors is associated with the ubiquitination of Akt and its targeting to the proteasome, where it is degraded. This results in a shortening of the half-life of Akt from 36 to 12 h and an 80% reduction in its expression. Akt and its activating kinase, PDK1, are the only members of the protein kinase A/protein kinase B/protein kinase C-like kinase family that are affected by Hsp90 inhibitors. Thus, transduction of growth factor signaling via the Akt and Raf pathways requires functional Hsp90 and can be coordinately blocked by its inhibition.
Augmented Renal Clearance in the ICU: Results of a Multicenter Observational Study of Renal Function in Critically Ill Patients With Normal Plasma Creatinine Concentrations*

Objective:To describe the prevalence and natural history of augmented renal clearance in a cohort of recently admitted critically ill patients with normal plasma creatinine concentrations. Design:Multicenter, prospective, observational study. Setting:Four, tertiary-level, university-affiliated, ICUs in Australia, Singapore, Hong Kong, and Portugal. Patients:Study participants had to have an expected ICU length of stay more than 24 hours, no evidence of absolute renal impairment (admission plasma creatinine < 120 µmol/L), and no history of prior renal replacement therapy or chronic kidney disease. Convenience sampling was used at each participating site. Interventions:Eight-hour urinary creatinine clearances were collected daily, as the primary method of measuring renal function. Augmented renal clearance was defined by a creatinine clearance more than or equal to 130 mL/min/1.73 m2. Additional demographic, physiological, therapeutic, and outcome data were recorded prospectively. Measurements and Main Results:Nine hundred thirty-two patients were admitted to the participating ICUs over the study period, and 281 of which were recruited into the study, contributing 1,660 individual creatinine clearance measures. The mean age (95% CI) was 54.4 years (52.5–56.4 yr), Acute Physiology and Chronic Health Evaluation II score was 16 (15.2–16.7), and ICU mortality was 8.5%. Overall, 65.1% manifested augmented renal clearance on at least one occasion during the first seven study days; the majority (74%) of whom did so on more than or equal to 50% of their creatinine clearance measures. Using a mixed-effects model, the presence of augmented renal clearance on study day 1 strongly predicted (p = 0.019) sustained elevation of creatinine clearance in these patients over the first week in ICU. Conclusions:Augmented renal clearance appears to be a common finding in this patient group, with sustained elevation of creatinine clearance throughout the first week in ICU. Future studies should focus on the implications for accurate dosing of renally eliminated pharmaceuticals in patients with augmented renal clearance, in addition to the potential impact on individual clinical outcomes.
Factors responsible for pulp cell cytotoxicity induced by resin-modified glass ionomer cements.

Resin-modified glass ionomer cements (RM-GICs) are the last generation of GICs commonly used in restorative dentistry. They contain various resins that improve their mechanical properties. These modifications, however, may also affect their biocompatibility. We compared the cytotoxicity of seven biomaterials (five RM-GICs, one metal-reinforced GIC (M-GIC), and a zinc-oxyphosphate cement) using an assay of pulp cell viability in vitro (MTT assay). The most toxic materials appeared to be the M-GIC Hi-Dense and the RM-GIC Vitremer. The less toxic ones appeared to be the RM-GICs Compoglass and Photac-Fil. Attempts made to identify the factors responsible for their cytotoxicity indicated that in vitro cytotoxicity did not seem to be caused by any change in pH of the biomaterial eluates. Adsorption of biomaterial eluates on dentin powder significantly reduced the cytotoxicity of all biomaterials. The concentration of F-, Sr2+, and Al3+ (major ionic elements present in GICs) in the eluate of six glass ionomer containing biomaterials was too low to be cytotoxic. However, Cu2+ and Ag+ (present in alloys of M-GIC) were present in toxic concentrations in Hi-Dense eluates. Unpolymerized monomers leached from resins were identified by Fourier transform IR spectroscopy in biomaterial eluates. The monomers hydroxyethyl methacrylate (HEMA), triethylene glycol dimethacrylate (TEGDMA), and poly(acrylic) acid were identified in eluates of Vitremer, Compoglass, and Hi-Dense, respectively. After ethanol elution of HEMA and TEGDMA from Vitremer and Compoglass, respectively, the cytotoxicity of these two RM-GICs was drastically reduced. Our results suggest that the principal compounds responsible for cytotoxicity are unpolymerized resin monomers in the two RM-GICs and Cu2+ and Ag+ in the M-GIC.
A Wider Range of Friends: Multi‐speed Organising during the 2015 Labour Leadership Contest

The British Labour party's recent adoption of a partially open primary for the selection of its leader conforms to a trend seen across many European political parties of increasing rights and privileges in internal party decision-making and expanding opportunities for more loosely affiliated supporters to participate in party activity. This dual trend can be seen as a response to changes in the membership environment, greater individualisation of political participation and growth in social movement politics and online activism. Yet as much as parties are responding to a changed membership environment, they are also driving that change, increasingly blurring the distinction between members and supporters. This article examines the recent impact of this change within the British Labour party and argues that, in line with Susan Scarrow's theory of ‘multi-speed’ membership, the Labour party's experiment in expanding affiliation options has led directly to a tension in locating the source of authority within the party, creating a challenge for its new leader in accommodating his new supporters within his party's representative traditions.
Nephrogenic Adenomas in Pediatric Patients: A Morphologic and Immunohistochemical Study of 21 Cases

Similar to nephrogenic adenomas in adults, those in children are rare benign lesions that often occur in the setting of previous surgery or chronic irritation of the urinary tract. These lesions often present with hematuria and/or as polypoid or papillary lesions on cystoscopy, which may indicate malignancy. We sought to evaluate the various patterns of nephrogenic adenoma occurring in the pediatric population and better characterize the immunophenotype of these lesions. We reviewed 21 cases of nephrogenic adenomas from urinary bladder biopsies of 16 patients. Most patients had a history of urinary bladder augmentation with recurrent urinary stones and urinary tract infections. Many cases presented as a papillary or polypoid mass on cystoscopy. The most common morphologic patterns are papillary, tubulocystic, and a mixed pattern of papillary and tubulocystic, followed by cystic and tubular. On immunostaining, PAX-2, PAX-8, CK7, and MUC-1 provided the most diffuse and intense positive reactivity for nephrogenic adenoma, whereas CD10 and P504S were focal and lesser in intensity when positive. p63 and PAX-5 were consistently negative. We conclude that, although rare in children, nephrogenic adenoma should be included in the differential diagnosis of papillary/polypoid lesions in the urinary tract, especially in the context of previous surgery, chronic irritation from recurrent urinary tract infections, or stones. The immunohistochemistry profile of nephrogenic adenomas in our study also provides evidence that these are derived from distal renal tubular cells. In difficult cases, an immunohistochemical panel consisting of cytokeratin 7, PAX-2, PAX-8, and MUC-1 may be useful.
Change in presurgical diagnostic imaging evaluation affects subsequent pediatric epilepsy surgery outcome

Since 2008, we have changed our presurgical diagnostic imaging evaluation for medically refractory focal epilepsy to include high‐resolution epilepsy protocol on 3 T magnetic resonance imaging (MRI), and combined magnetoencephalography and 18‐fluorodeoxyglucose–positron emission tomography (FDG‐PET) in selected patients with normal or subtle changes on MRI or discordant diagnostic tests. The aim of this study was to evaluate the effectiveness of the change in imaging practice on epilepsy surgery outcome in a tertiary pediatric epilepsy surgery center.
Is Antithrombotic Prophylaxis Required After Liver Transplantation in HIV‐Infected Recipients?

Multiple acquired and persistent thrombophilic abnormalities have been observed in HIV-infected patients leading authors to recognize HIV infection as a prothombotic state with potential implications after transplantation (1). Recently, five cases of arterial complications in 24 HIVinfected liver transplant recipients have been reported by Cherian et al. (2) including three cases of hepatic artery thrombosis (HAT). The rate of HAT in the HIV-positive and the HIV-negative recipients was 12% and 3.2%, respectively (p = 0.016). The authors concluded that there is a trend toward an increased risk of HAT in this population and recommended a full coagulopathy screen at the transplant assessment and a risk-adapted case-by-case consideration of antithrombotic prophylaxis for HIV-infected recipients.