Miracle-dz/UniFAR-FTUs huggingface dataset:
HER2 overexpression in muscle‐invasive urothelial carcinoma of the bladder: Prognostic implications

The HER2 (c‐erbB‐2) receptor is overexpressed in a variety of human malignant tumors and, in breast carcinoma, has been identified as a target for anti‐HER2–directed therapy with the monoclonal antibody (MAb) trastuzumab. The aim of this retrospective study was to evaluate immunohistochemic HER2 expression in a large cohort of muscle‐invasive urothelial cell carcinomas of the urinary bladder and to compare the results to pathologic characteristics and survival. Paraffin‐embedded tumor specimens from 138 patients undergoing radical cystectomy for muscle‐invasive bladder carcinoma were studied immunohistochemically with the Food and Drug Administration (FDA)‐approved HercepTest (Dako, Glostrup, Denmark). HER2 overexpression was observed in 57 of 138 tumors (41%) and occurred more frequently in high‐grade carcinomas than in low‐grade carcinomas (p = 0.036). No significant relationship with HER2 overexpression was registered for tumor staging and lymph node status. Kaplan‐Meier curves showed a significantly worse disease‐related survival (p = 0.034) in patients with HER2‐overexpressing tumors compared to those without HER2 overexpression. In addition to lymph node status (p = 0.0001; relative risk [RR] = 2.93), HER2 status (p = 0.020; RR = 2.22) was identified as an independent predictor for disease‐related survival in a multivariate analysis. These results suggest that HER2 expression might provide additional prognostic information in patients with muscle‐invasive bladder carcinomas. Because many of these patients harbor HER2‐overexpressing tumors, clinical trials evaluating the efficacy of trastuzumab in bladder carcinoma are warranted. © 2002 Wiley‐Liss, Inc.
Associations Between Heavy-Vehicle Driver Compensation Methods, Fatigue-Related Driving Behavior, and Sleepiness

Objective: There has been growing recognition that broader economic and organizational factors play a role in creating work environments that facilitate high-risk driving behavior. This study investigates the association between compensation methods for drivers, fatigue-related driving behavior, and sleepiness among Australian heavy-vehicle drivers. Specifically, we hypothesized that piece-rate compensation methods linked to performance outcomes would be associated with greater levels of fatigue-related driving behaviors and sleepiness. Methods: We examined data from a random sample of 346 long-haul heavy-vehicle drivers who had not been involved in a crash. A 40-min interview was conducted that elicited information regarding driver demographics, truck characteristics, and compensation arrangements. Specific details about drivers’ behavior on their most recent trip including load(s) carried, distances driven, hours driven, rest breaks, and hours of sleep on the previous night were taken. The interview also included a standardized assessment of sleepiness using the Epworth Sleepiness Scale (ESS). Results: A multivariate analysis of covariance demonstrated a significant multivariate effect for compensation methods across the combined, fatigue-related driving behavior dependent variables, F (10, 676) = 2.80, p <. 01. Between-subject effects demonstrated significant association between compensation methods and 4 of 5 fatigue-related variables under study, including kilometers driven per day, F (2, 340) = 7.75, p <. 001, hours driven per day, F (2, 341) = 2.64, p <. 05, total hours worked per week, F (2, 340) = 5.27, p <. 01, and mean driving time between breaks, F (2, 341) = 4.45, p <. 05. Post hoc tests revealed that piece-rate compensation methods were associated with higher levels of fatigue-related driving than non-piece-rate methods. Follow-up analysis also revealed higher caffeine and amphetamines use among piece-rate drivers for the purpose of staying awake while driving. Despite this, no association between compensation methods and sleepiness were revealed. Conclusions: Results confirmed that performance-based compensation methods are associated with work practices that may exacerbate driving behaviors associated with fatigue. Despite this finding, however, performance-based compensation methods were not associated with higher levels of sleepiness. This highlights the presence of potential differences in self-selection, operational, or fatigue management practices that may be common to drivers paid under various methods. Implications of these results for safety policy and future safety research within the heavy-vehicle industry are discussed.
Aging reduces the cardioprotective effect of ischemic preconditioning in the rat heart.

Multiple brief periods of ischemia in the mammalian heart elicits protection against morphologic and functional damage caused by longer-duration ischemia. Preconditioning-induced protection against post-ischemic contractile dysfunction has been reported to be depressed with aging of the adult heart. This study was undertaken to determine whether aging of the adult myocardium reduces the preconditioning-induced attenuation of necrosis observed with ischemia. Isolated, perfused hearts obtained from Fischer 344 rats of either 3 (young) or 22 (aged) months of age were paced and instrumented for determination of developed left ventricular pressure. Necrosis was determined with triphenyltetrazolium. In the absence of preconditioning, young and aged adult hearts made globally ischemic for 45 min developed necrosis involving 53+/-6% and 49+/-6% of the myocardium, respectively. Contractile function (+dP/dt(max)) at 90 min of reperfusion was depressed by 80% in young and 52% in aged hearts, compared to values obtained prior to preconditioning. Preconditioning with two 5 min ischemia/5 min reperfusion cycles significantly reduced necrosis development and enhanced reperfusion contractile function in young hearts. However, in aged adult hearts, the preconditioning did not significantly reduce the development of necrosis or enhance reperfusion contractile function. These data suggest that aging reduces the effectiveness of preconditioning in providing cardioprotection against ischemic-induced myocardial necrosis.
Fiscal decentralisation and economic theory

There is no complete overview or discussion of the literature of the economics of federalism and Fiscal decentralization, even though scholarly interest in the topic has been increasing significantly over recent years. This paper provides a general, brief but comprehensive overview of the main insights from the literature on fiscal federalism and decentralization. In doing so, literature on fiscal federalism and decentralization is grouped into two main approaches: "first generation of theories" and "second generation of theories".
Neonatal Nurses' Perceptions of Pain Assessment and Management in NICUs: A National Survey

PURPOSE:The purpose of this survey was to investigate neonatal nurses' perceptions of knowledge and practice in pain assessment and management. METHODS:A convenience sample consisted of 237 neonatal nurses with a membership in National Association of Neonatal Nurses (NANN) and neonatal nurses in Connecticut who were not NANN members. A researcher-developed questionnaire, including 36 questions with Likert scale and 2 open-ended questions, was used. RESULTS:The nurses were knowledgeable, and about 50% felt that they received adequate training and continuing education on pain. Participants reported the use of pain assessment tools (81%) and felt confident in uses of pharmacologic (83%) and nonpharmacologic interventions (79%). More than half felt that the pain tool used in their unit was appropriate for neonates (65%) and was an accurate measure (60%). Fewer than half reported that pain was well managed (44%) and that their pain protocols were research evidence based (43%). CONCLUSIONS:Nurses' perceptions of well-managed pain were significantly correlated with training, use of appropriate and accurate pain tools, and clear and research-based protocols. Barriers to effective pain management emerged as resistance to change, lack of knowledge, perceived fear of side effects of pain medication and incorrect interpretation of pain signals, lack of time, and lack of trust in the pain assessment tools. Gaps exist in knowledge, evidence, and practice in neonatal assessment and management.
Causes and consequences of decreasing atmospheric organic aerosol in the United States

Significance Ambient particulate matter (PM) was responsible for four million premature deaths globally in 2012. The deleterious health impacts of PM motivated the US Environmental Protection Agency (EPA) to curtail emission of PM and precursor gases. The 2011 EPA report to Congress on the efficacy of the Clean Air Act estimated a dramatic reduction in human mortality resulting from these emissions controls. Surface measurements from 1990 to 2012 indicate a significant US-wide decline in the organic portion of the PM, not accounted for in the EPA report. We show that the decline in organic aerosol is mediated primarily through changes in vehicle and residential fuel-burning emissions, indicating that the Clean Air Act is even more beneficial to US air quality than currently appreciated. Exposure to atmospheric particulate matter (PM) exacerbates respiratory and cardiovascular conditions and is a leading source of premature mortality globally. Organic aerosol contributes a significant fraction of PM in the United States. Here, using surface observations between 1990 and 2012, we show that organic carbon has declined dramatically across the entire United States by 25–50%; accounting for more than 30% of the US-wide decline in PM. The decline is in contrast with the increasing organic aerosol due to wildfires and no clear trend in biogenic emissions. By developing a carbonaceous emissions database for the United States, we show that at least two-thirds of the decline in organic aerosol can be explained by changes in anthropogenic emissions, primarily from vehicle emissions and residential fuel burning. We estimate that the decrease in anthropogenic organic aerosol is responsible for averting 180,000 (117,000–389,000) premature deaths between 1990 and 2012. The unexpected decrease in organic aerosol, likely a consequence of the implementation of Clean Air Act Amendments, results in 84,000 (30,000–164,000) more lives saved than anticipated by the EPA between 2000 and 2010.
The relationship between output and asset prices: A time – and frequency – varying approach

This paper employs wavelet analysis to examine the relationship between the U.S. output and asset prices. We use the theory of the monetary transmission mechanism to explain the relationship between them. Wavelet analysis takes the simultaneous examination of co-movement and causality into account in both the time and frequency domains. We do find the positive correlation between each two series in the time domain. More specifically, the output and asset prices including oil, stock and house prices exhibit positive co-movement in the most of the sample period. However, the relationship between output and gold prices is a positive correlation for only a few years. From the frequency domain, output and stock, house prices correlate with each other across different frequencies. In addition, output and oil prices correlate at middle (medium run) and higher (short run) frequencies and output and gold prices correlate at higher (short run) frequencies. These findings offer important implications analysing how to apply assets prices to forecast output and analysing periodic variation of economic growth and economical sustainability for policymakers and practitioners.
Expecting the Unexpected: Predicting Physiological and Psychological Wildfire Preparedness from Perceived Risk, Responsibility, and Obstacles

People who live in wildfire‐prone communities tend to form their own hazard‐related expectations, which may influence their willingness to prepare for a fire. Past research has already identified two important expectancy‐based factors associated with people's intentions to prepare for a natural hazard: Perceived risk (i.e., perceived threat likelihood and severity) and perceived protection responsibility. We expanded this research by differentiating the influence of these factors on different types of wildfire preparedness (e.g., preparations for evacuation vs. for defending the house) and measured actual rather than intended preparedness. In addition, we tested the relation between preparedness and two additional threat‐related expectations: the expectation that one can rely on an official warning and the expectation of encountering obstacles (e.g., the loss of utilities) during a fire. A survey completed by 1,003 residents of wildfire‐prone areas in Perth, Australia, revealed that perceived risk (especially risk severity) and perceived protection responsibility were both positively associated with all types of preparedness, but the latter did not significantly predict preparedness after controlling for other predictors and demographics. Also, the two new expectancy‐based factors were significantly associated with all types of preparedness, and remained significant predictors of some types of preparedness after controlling for other predictors and demographics: the expectation of being able to rely on an official fire warning and expecting to lose electricity both still predicted less preparedness around house resilience, and expecting to lose water still predicted increased planning preparedness. We discuss public policy implications that follow from this research.
Neuroprotective potential of phytochemicals

Cognitive dysfunction is a major health problem in the 21st century, and many neuropsychiatric disorders and neurodegenerative disorders, such as schizophrenia, depression, Alzheimer's Disease dementia, cerebrovascular impairment, seizure disorders, head injury and Parkinsonism, can be severly functionally debilitating in nature. In course of time, a number of neurotransmitters and signaling molecules have been identified which have been considered as therapeutic targets. Conventional as well newer molecules have been tried against these targets. Phytochemicals from medicinal plants play a vital role in maintaining the brain's chemical balance by influencing the function of receptors for the major inhibitory neurotransmitters. In traditional practice of medicine, several plants have been reported to treat cognitive disorders. In this review paper, we attempt to throw some light on the use of medicinal herbs to treat cognitive disorders. In this review, we briefly deal with some medicinal herbs focusing on their neuroprotective active phytochemical substances like fatty acids, phenols, alkaloids, flavonoids, saponins, terpenes etc. The resistance of neurons to various stressors by activating specific signal transduction pathways and transcription factors are also discussed. It was observed in the review that a number of herbal medicines used in Ayurvedic practices as well Chinese medicines contain multiple compounds and phytochemicals that may have a neuroprotective effect which may prove beneficial in different neuropsychiatric and neurodegenerative disorders. Though the presence of receptors or transporters for polyphenols or other phytochemicals of the herbal preparations, in brain tissues remains to be ascertained, compounds with multiple targets appear as a potential and promising class of therapeutics for the treatment of diseases with a multifactorial etiology.
Dosimetric consequences of gold nanoparticle clustering during photon irradiation

Purpose: The radiation dose enhancement caused by introducing gold nanoparticles (GNP) into cells can increase the dose locally absorbed. A disconnect between experimentally determined survival and dose enhancements predicted by Monte Carlo simulations on macroscopic scales, suggests small‐scale energy deposition patterns play an important role in GNP dose enhancement. Clustering of the GNPs could potentially alter small‐scale energy deposition patterns. Here we use Monte Carlo simulations to quantify energy deposition patterns in the presence of clustered GNPs and address the question of whether clustering of the nanoparticles affects the energy deposition patterns and ultimately cellular response. Methods: Using the PENELOPE Monte Carlo code, we examine the absorption of energy in the environment of a single irradiated GNP following its interaction with a set of primary monoenergetic photon beams. We introduce successive GNPs to form a cluster about the particle in which the primary photon interactions occur and report on the energy deposited locally (within a 500 nm radius) and nonlocally (beyond 500 nm) in the surrounding water‐equivalent medium as a function of the number of additional GNPs and the packing geometry they assume. Results: When additional GNPs cluster in tightly packed formations about a GNP in which an incident photon interacts, both the energy deposited locally and released nonlocally are reduced relative to the case where other GNPs are not present. The degree of the reduction depends on incident photon energy, the number of GNPs added to the cluster, and the packing geometry. With 90 additional GNPs in a hexagonal close packing (HCP) cluster about a directly irradiated test particle, the local energy deposition was reduced to 29% (of the value in the absence of neighbors) in the most extreme monoenergetic case. Energy released into the nonlocal volume was most affected by the cluster for low‐incident photon energies (< 40 keV), where reductions to 26% of the value in the absence of a cluster were shown. The packing geometry mitigated these results. When the irradiated GNP was on the periphery of the HCP cluster, or when the cluster was confined to a plane, the observed effects were weaker and when an equal number of GNPs were uniformly distributed in the local volume, the changes were trivial (less than 2%). Conclusions: The findings provide grounds for reconciling the observations of cell survival with Monte Carlo predictions of GNP dose enhancement. This work is significant because it demonstrates that GNP clustering needs to be understood and accounted to optimize local dose enhancement.
Differences in the Definitions Used for Esophageal and Gastric Diseases in Different Countries

Background: Definitions and opinions in the field of gastroenterology vary widely in different countries. Methods: Here we discuss four such important differences: the definition of the esophagogastric junction (EGJ), the possible precursor of Barrett’s adenocarcinoma, the definition of Barrett’s esophagus (BE), and the histologic criteria for mucosal adenocarcinoma. In addition, we consider which definitions and opinions might be valid and practical. Results: There are two different endoscopic definitions of the EGJ. Our research on German subjects has indicated that many small Barrett’s adenocarcinomas may arise not in the intestinal-type but in the cardiac-type mucosa. If an area of columnar-lined esophagus (CLE) is only partially involved by intestinal metaplasia, then the latter cannot always be demonstrated in biopsy specimens. Therefore, we do not think that a definition of BE as CLE with histologic intestinal metaplasia is practical. Data from the literature have shown that many cases of high-grade dysplasia (HGD) progress to carcinoma within a very short time, and in most such cases the carcinoma has been underdiagnosed in biopsy specimens as HGD. Conclusion: With regard to the definitions and opinions, an exchange of views between gastroenterologists in North America, Europe, and Japan would be desirable.
Role of radical surgery in patients with stage IV gallbladder cancer.

OBJECTIVES The role of surgery in stage IV gallbladder (GB) cancer is not well established. This study analyses prognostic factors in patients with stage IV GB cancer following surgical resection with the aim of identifying a subgroup of patients who might benefit from surgical resection. METHODS Clinicopathological details were analysed for 94 patients who were surgically treated for stage IV GB cancer at Seoul National University Hospital. RESULTS Median survival was 8 months in patients with either stage IVa or IVb disease. Sixteen patients (17.0%) underwent resection with curative intent, which increased overall survival over that in patients undergoing palliative surgery (P < 0.001). No survival benefit was seen following surgery with curative intent in patients with stage IVa disease (P = 0.764). Surgery with curative intent resulted in a survival benefit in patients with stage IVb disease, patients with an isolated liver metastasis near the GB bed (median survival: 31 months vs. 9 months; P < 0.001) and patients with limited numbers of peritoneal implantations (median survival: 20 months vs. 6 months; P = 0.002). Preoperative serum carcinoembryonic antigen (CEA) (P = 0.018), surgery with curative intent (P = 0.045) and adjuvant chemotherapy (P = 0.002) were independent prognostic factors in patients with stage IV GB cancer. CONCLUSIONS Surgery in combination with systemic chemotherapy may be beneficial in carefully selected patients with stage IVb GB cancer.
Etiologies and characteristics of children with chief complaint of short stature

Purpose Short stature is a very common reason for visits to pediatric endocrine clinics. It could be the first sign of an underlying disease. The purpose of this study is to investigate the etiologies and general characteristics of subjects who visited an outpatient clinic due to short stature. Methods We retrospectively reviewed the medical records of 3,371 patients who visited Severance Children's Hospital with the chief complaint of short stature from 2010 to 2012. Medical history, auxological data, and laboratory tests including bone age were collected and analyzed. Chromosome studies or combined pituitary function tests were performed if needed. Results Approximately 89.4% of the subjects with the chief complaint of short stature who visited the outpatient clinic were of normal height, and only 10.6% of subjects were identified as having short stature. Of the subject of short stature, 44.7% were classified as having normal variant short stature; that is, familial short stature (23.0%), constitutional delay in growth (17.7%), and mixed form (3.9%). Pathological short stature was found in 193 subjects (54.2%). Among pathological short stature, most common etiology was growth hormone deficiency (GHD) (38.9%). Conclusion A majority of children had a normal height. Among children with short stature, pathological short stature and normal variants occupied a similar percentage. GHD was the most common cause of pathological short stature and found in about 20% of the children with short stature. In pathological short stature, the height, height velocity, and IGF-1 level were lower than in normal variants.