Miracle-dz/UniFAR-FTUs huggingface dataset:
Enhanced Recovery after Surgery for Gastric Cancer

Introduction: While FTS programs are developing in colo-rectal surgery, in upper gastrointestinal surgery they are rare. ERAS programs can be planned and performed in gastric cancer surgery as pre-, intra- and post-operative. Materials and methods: We have studied 178 gastric cancer patients operated radically in our clinic between 2000 and 2011, comparing outcomes of surgical strategies containing FTS elements. Standard gastrectomies with D2 lymph node dissection were made: esophago-cardial resections - 32; total gastrectomies - 78, proximal gastrectomies - 21; distal gastrectomies - 47. Patient’s files were inspected for 19 perioperative indicators applicable to FT surgery. Data for abdominal complaints and early postoperative complications were also collected and analyzed. Results: Only 42 patients fulfilled the criteria for ERAS intervention, having at least 5 ERAS indicators. The most common FT elements were: lack or removing naso-gastric tube, oral intake and mobilization on postoperative day 1 - 2 and one shot AB prophylaxis. From the 8 types of complications studied, most common were: wound infection - 12.9% and anastomosis dehiscence - 4.5%. Lethality was 6.2%. Six patients died from pulmonary embolism, bronchopneumonia and heart attack. Reoperations for complications were performed in 19 patients, 5 of whom died. Mean hospital stay was - 15.2 days. Discussion and conclusions: In patients mobilized early, fed orally and deprived from nasogastric tube and urinary catheter on day 1-2, flatus and defecation appeared earlier, wound infections, pulmonary hypostasis and pneumonia rate were lower and hospital stay was less, which coincides with other reports. Usual insertion of nasogastric tubes, urinary catheters and intra-abdominal drains after gastric cancer resection should be avoided. FTS in gastrectomy for gastric cancer is safe and efficient approach, which hasten return of gut function and shorten postoperative hospital stay.
Early gametocytes of the malaria parasite Plasmodium falciparum specifically remodel the adhesive properties of infected erythrocyte surface

In Plasmodium falciparum infections the parasite transmission stages, the gametocytes, mature in 10 days sequestered in internal organs. Recent studies suggest that cell mechanical properties rather than adhesive interactions play a role in sequestration during gametocyte maturation. It remains instead obscure how sequestration is established, and how the earliest sexual stages, morphologically similar to asexual trophozoites, modify the infected erythrocytes and their cytoadhesive properties at the onset of gametocytogenesis. Here, purified P. falciparum early gametocytes were used to ultrastructurally and biochemically analyse parasite‐induced modifications on the red blood cell surface and to measure their functional consequences on adhesion to human endothelial cells. This work revealed that stage I gametocytes are able to deform the infected erythrocytes like asexual parasites, but do not modify its surface with adhesive ‘knob’ structures and associated proteins. Reduced levels of the P. falciparum erythrocyte membrane protein 1 (PfEMP1) adhesins are exposed on the red blood cell surface bythese parasites, and the expression of the var gene family, which encodes 50–60 variants of PfEMP1, is dramatically downregulated in the transition from asexual development to gametocytogenesis. Cytoadhesion assays show that such gene expression changes and host cell surface modifications functionally result in the inability of stage I gametocytes to bind the host ligands used by the asexual parasite to bind endothelial cells. In conclusion, these results identify specific differences in molecular and cellular mechanisms of host cell remodelling and in adhesive properties, leading to clearly distinct host parasite interplays in the establishment of sequestration of stage I gametocytes and of asexual trophozoites.
Sharing, Saving, and Living Well on Less: Supporting Social Connectedness to Mitigate Financial Hardship

ABSTRACT This article contends that problems such as poverty and economic disadvantage are equally social in their nature as they are economic. As such, a social frame of reference is helpful in design. Using a qualitative approach, the authors studied the ways that 13 Australian households living on a low income manage, organize, and interact in their everyday financial activities and what this means for designers of technology that might assist them with this. The article highlights the highly social nature of many practices concerned with managing and saving money. Implications are provided for how these practices may be supported through fostering social connections and how informal and sharing economies may be leveraged to provide value to those experiencing financial hardship. An argument is made that classifying an otherwise heterogeneous population based on income alone is reductive. In response, the authors propose a rationale for amending the “low income” demographic classifier, incorporating a broader measure they tentatively term Social–financial Connectedness, which captures the importance of social connections in overall financial well-being and identifies people’s capacity to live well and share, irrespective of their financial circumstances.
Divalent cations in women with PCOS: implications for cardiovascular disease

Polycystic ovary syndrome (PCOS) patients are known to have a high incidence of insulin resistance and glucose intolerance and tend to be at eventual high risk of hypertension ,diabetes mellitus and cardiovascular disease. It has been repeatedly shown that a low serum ionized magnesium (Mg2+) and a high ionized calcium to magnesium (Ca2+/Mg2+) ratio is often associated with insulin resistance ,cardiovascular problems ,diabetes mellitus and hypertension. We were therefore interested in assessing the serum divalent cation profile of PCOS patients compared with that of normal women of similar age. We found significantly lower serum Mg2+ and total magnesium and a significantly higher serum Ca2+/Mg2+ ratio in the PCOS patients compared with the controls. No correlation was found ,however ,between the serum concentrations of steroid hormones (estrogen ,progesterone and testosterone) ,or any of the cations in the PCOS patients or the controls.
Nurse triage in accident and emergency departments.

mammography. Lancet 1985;i: 829-32. 3 Day NE, Walter SD, Collette B. Statistical models of disease natural history: their use in the evaluation of screening programmes. In: Prorok PC, Miller AB, eds. Screening for cancer. I. General principles on evaluation of screeningfor cancer and screening for lung, bladder and oral cancer. Geneva: International Union Against Cancer, 1984:55-70. (Technical report No 78.) 4 Duffy SW, Tabar L, Fagerberg G, Gad A, Grontoft 0, South MC, et al. Breast screening, prognostic factors and survivalresults from the Swedish two-county study. Br J Cancer 1991 ;64: 1133-8. 5 Andersson I, Aspegren K; Janzon L, Landberg T, Lindholm K, Linell F. Mammographic screening and mortality from breast cancer: the Maldno mammographic screening trial. BMJ 1988;297:943-8. 6 Miller AB, Baines CJ, To T, Wail C. The Canadian national breast screening trial. In: Miller AB, Chamberlain J, Day NE, Hakama M, Prorok PC, eds. Cancer screening. Cambridge: Cambridge-University Press, 1991:45-55. 7 Frisell J, Eklund G, Hellstrom L; Lidbrink E, Rutqvist LE, Somell A. Randomized study of mammography screeningpreliminary report on mortality in the Stockholm trial. Breast Cancer Res Treat 1991;18:49-56. 8 Tabar L, Fagerberg G, Duffy SW, Day NE, Gad A, Grontoft 0. Update of the Swedish two-county program ofmammographic screening for breast cancer. Radiol Clin N Am 1992;30: 187-210.
Zinc improves gene transfer mediated by DNA/cationic polymer complexes

The weak efficiency of plasmid transfer into the cytosol remains one of the major limiting factors to achieve an efficient transfection with DNA/cationic polymer complexes. We found that divalent metal Zn2+ can improve the polyfection efficiency, especially with DNA/histidylated polylysine (His‐pLK) complexes.
A "loading port" for syringe infusion pumps.

1. Lee VC. When sympathectomy fails to relieve causalgic burning pain. Anesth Analg 1990;71:3134. 2. De Jong RH. Neuropathic pain may not respond to sympathetic blockade. Anesth Analg 1990:71:314. 3. Cicala RS, Jones JW, Westbrook LL. Causalgic pain responding to epidural but not to sympathetic nerve blockade. Anesth Analg 1990;70: 2 W 9 . 4. Benzon HT Increase in skin temperature, by itself, may not indicate complete sympathetic blockade. Anesth Analg 1988;67716. 5. Benzon HT, Cheng SC, Avram MJ, Molloy RE. Sign of complete sympathetic blockade: sweat test or sympathogalvanic response? Anesth Analg 1985;64:41.59. 6. Lewis LW. Evaluation of sympathetic activity following chemical or surgical sympathectomy. Anesth Analg 1955;34:3345. 7. Benzon HT, Avram MJ. Temperature increases after complete sympathetic blockade. Reg Anesth 1986;11:27-30. 8. Cousins MJ, Bridenbaugh PO. Neural blockade in clinical anesthesia and management of pain. 2nd ed. Philadelphia: JB Lippincott, 1988:461-4, 887-9. 9. Kim JM, LaSalle AD, Parmley RT. Sympathetic recovery following lumbar epidural and spinal analgesia. Anesth Analg 1977;56352-5.
Determination of veterinary pharmaceuticals in poultry litter and soil by methanol extraction and liquid chromatography-tandem mass spectrometry

Pharmaceuticals are emerging contaminants with potential risks to the environment and human health. A liquid chromatography-tandem mass spectrometry (LC-MS-MS) method was developed for determination of the antimicrobials virginiamycin, monensin, salinomycin, narasin and nicarbazin in poultry litter and soil. This method involves methanol extraction and clean-up of extracts through glass microfibre filters, introduction of the extracts and separation of compounds on a Zorbax Eclipse XDB C8 column, and compound detection in a Quattro Micro Micromass spectrometer. For litter samples, Method Detection Limits ranged from 0.1–0.6 μg Kg− 1, while Limits of Quantitation (LOQs) were 2, 1, 0.4, 1 and 2 μg Kg− 1 for virginiamycin, monensin, salinomycin, narasin and nicarbazin, respectively. For soil samples calculated LOQs were 2, 3, 1, 1, and 1 μg Kg− 1 for virginiamycin, monensin, salinomycin, narasin and nicarbazin, respectively. Application of the LC-MS-MS method for detection of veterinary pharmaceuticals in litter collected from commercial poultry farms showed that compounds were present at concentrations ranging from 10–11,000 μg Kg− 1.
Recurrent reflux and wrap disruption after Nissen fundoplication: Detection, incidence and timing

One hundred and twenty‐five patients with refractory gastro‐oesophageal reflux disease underwent floppy Nissen fundoplication. Median follow‐up was 52 months, and included endoscopy, manometry and prolonged pH recordings in all cases in addition to clinical assessment. Using objective criteria, 12patients (9·6per cent) developed recurrent reflux. In nine of these patients, endoscopy had suggested that the Nissen fundoplication had disrupted; wrap disruption was confirmed in seven patients who underwent reoperation. The median time to endoscopic recognition of wrap disruption was 7 months (range 3–10 months). In contrast, of 115 patients with endoscopic evidence of an intact fundoplication, only 3 (2·6 per cent) had recurrent reflux. Endoscopy allowed reliable differentiation between those with and without reflux control after operation (P< 0·007). These results suggest that recurrent reflux after Nissen fundoplication is due to wrap disruption. This phenomenon occurs within the first postoperative year and can be recognized by informed endoscopic assessment.
The Hsp40 Molecular Chaperone Ydj1p, Along With the Protein Kinase C Pathway, Affects Cell-Wall Integrity in the Yeast Saccharomyces cerevisiae

Molecular chaperones, such as Hsp40, regulate cellular processes by aiding in the folding, localization, and activation of multi-protein machines. To identify new targets of chaperone action, we performed a multi-copy suppressor screen for genes that improved the slow-growth defect of yeast lacking the YDJ1 chromosomal locus and expressing a defective Hsp40 chimera. Among the genes identified were MID2, which regulates cell-wall integrity, and PKC1, which encodes protein kinase C and is linked to cell-wall biogenesis. We found that ydj1Δ yeast exhibit phenotypes consistent with cell-wall defects and that these phenotypes were improved by Mid2p or Pkc1p overexpression or by overexpression of activated downstream components in the PKC pathway. Yeast containing a thermosensitive allele in the gene encoding Hsp90 also exhibited cell-wall defects, and Mid2p or Pkc1p overexpression improved the growth of these cells at elevated temperatures. To determine the physiological basis for suppression of the ydj1Δ growth defect, wild-type and ydj1Δ yeast were examined by electron microscopy and we found that Mid2p overexpression thickened the mutant's cell wall. Together, these data provide the first direct link between cytoplasmic chaperone function and cell-wall integrity and suggest that chaperones orchestrate the complex biogenesis of this structure.
Perianal actinomycetoma experience of 20 cases

Background Actinomycetoma is a chronic infection resulting from aerobic Actinomycetes. The major agents are Nocardia brasiliensis, Actinomadura madurae, and Streptomyces somaliensis. The most frequent topographies are the lower and upper limbs. The prognosis of this disease is determined by several factors, such as etiologic agent, clinical topography, and depth of disease (degree of involvement, visceral, and bone affection). The purpose of this paper was to present our experience with actinomycetoma of the perianal region.
Israeli oncology and nononcology nurses' attitudes toward physician-assisted dying: a comparison study.

PURPOSE/OBJECTIVES To compare the attitudes of Israeli oncology and nononcology nurses toward physician-assisted dying (PAD) and its legalization and to determine the factors that may be related to their attitudes. DESIGN Nonrandomized, correlational study. SETTING A teaching hospital in Jerusalem, Israel. SAMPLE 71 oncology nurses and 52 nurses working in the maternity and nursery departments. RESULTS The majority of nurses supported PAD and its legalization, with the greatest support being given when a suffering patient was involved. In the vignettes dealing with the nurse-patient relationship, oncology nurses were significantly less likely than nononcology nurses to agree with PAD but more likely to stay with their patients while the lethal drug was being given. Nononcology nurses were more supportive of legalization than oncology nurses. Religious nurses and nurses who observed religious traditions were significantly less likely to support PAD or vote for its legalization. CONCLUSION Israeli nurses generally are supportive of PAD. However, oncology nurses were less likely to support its practice. In addition, the more religious nurses considered themselves, the less likely they were to support the practice. IMPLICATIONS FOR NURSING PRACTICE Israeli nurses need to be made aware of the ethical, social, and legal implications of PAD and its legalization for the Israeli nursing profession. In addition, more cross-cultural research on attitudes toward PAD needs to be conducted.
Tamoxifen in Disseminated Breast Cancer

86 postmenopausal women with disseminated breast cancer have been treated orally with 30 mg of Tamoxifen per day (ICI 46474, Nolvadex) for periods of 2 months or more. The overall responders were 28/86 (32.5 %) with a median remission duration of 9 months. In 30 patients already shown to be resistant to cytotoxic chemotherapy, Tamoxifen was used as first hormonal agent; the remission rate in this group was 12/30 (40 %), while it was 28.5 % (16/56) in the others who had already received different hormonal treatments. In 6 early menopausal cases, the treatment had to be stopped for a dangerous « worsening syndrome ». Other side effects were trivial. In 28/35 cases (80%), we have found the reappearance of a pattern of estrogenic activity in vaginal smears during treatment. Hence a « simil-estrogen », more than an « anti-estrogen » mechanism of action is postulated and a selection of patients for treatment in the « mid postmenopausal age » is recommanded.
Percutaneous Endoscopic Gastrostomy Complications in a Tertiary-Care Center

Since its introduction in 1980 the percutaneous endoscopic gastrostomy (PEG) has become the procedure of choice for establishing enteral access. However, there is still a relatively high complication rate associated with PEG placement. We reviewed the complications associated with PEG placement at our tertiary-care referral center. A retrospective chart review was conducted on patients over 17 years of age undergoing PEG placement between January 1, 1994 and March 1, 1996. Indications for surgery, antibiotic use, and postoperative complications were determined. There were 166 PEGs placed during this time and 27 (16.3%) complications. There was one death (0.6%) directly related to PEG placement. Thirteen patients (7.8%) died within 30 days of PEG placement and an additional 12 patients (7.2%) died before leaving the hospital. Wound infections occurred in nine (5.4%) patients including one case of necrotizing fasciitis. Only four of 153 (2.6%) patients who received preoperative antibiotics developed wound infections, whereas five of 13 (38.5%) patients without antibiotic prophylaxis developed infections. We conclude that percutaneous endoscopic gastrostomy is a safe and effective way of establishing enteral access in most patients. A relatively high mortality rate can be expected as a result of underlying medical problems. Antibiotics should be given to help prevent local wound infections.
Treatment of class III multiple gingival recessions: a randomized-clinical trial.

BACKGROUND The aim of this controlled randomized split-mouth study was to evaluate whether a modified tunnel/connective tissue graft (CTG) technique - enamel matrix derivative (EMD) combination will improve the treatment of multiple class III recession when compared with the same technique alone. MATERIALS AND METHODS Twenty healthy subjects with a mean age of 31.7 years, were enrolled for the trial in a university periodontal clinic. Patients with at least three adjacent gingival recessions on both sides of the mouth were treated with a modified tunnel/CTG technique. On the test side, an EMD was used in addition. Clinical parameters were measured at baseline, 28 days, 3, 6 and 12 months after the surgery. Results are presented at the subject level. RESULTS The mean root coverage from baseline to 1 year post-surgery was 82% for the test group and 83% for the control group. Complete root coverage was achieved at 1 year in eight (38%) of the 20 surgeries (experimental and control group). CONCLUSIONS One-year results indicate that the modified tunnel/CTG technique is predictable for the treatment of multiple class III recession-type defects. The addition of EMD does not enhance the mean clinical outcomes.
Functional ratios among leaf, xylem and phloem areas in branches change with shade tolerance, but not with local light conditions, across temperate tree species.

Leaf, xylem and phloem areas drive the water and carbon fluxes within branches and trees, but their mutual coordination is poorly understood. We test the hypothesis that xylem and phloem areas increase relative to leaf area when species are selected for, or branches are exposed to, higher levels of light intensity. Trees of 10 temperate, broadleaved and deciduous, tree species were selected. Fifty-centimetre-long branches were collected from shaded and exposed conditions at a height of 3-4 m. We measured the total leaf area, xylem area, phloem area and leaf traits, as well as the area of the constituent cell types, for a stem section at the branch base. Xylem area : leaf area and phloem area : leaf area ratios did not differ consistently between sun and shade branches, but, as expected, they decreased with species' shade tolerance. Similar trends were observed for conductive cell areas in xylem and phloem. Trees of light-demanding species maintain higher water loss and carbon gain rates per leaf area by producing more xylem area and phloem area than shade-tolerant species. We call for more comparative branch studies as they provide an integrated biological perspective on functional traits and their role in the ecology of tree species.
Expression and Characterization of the Peptidase Domain of Streptococcus pneumoniae ComA, a Bifunctional ATP-binding Cassette Transporter Involved in Quorum Sensing Pathway*

ComA, a member of the bacteriocin ATP-binding cassette transporters, is postulated to be responsible for both the processing of the propeptide ComC and secretion of the mature competence-stimulating peptide, which regulates the competence and subsequent genetic transformation in Streptococcus pneumoniae. A recombinant N-terminal peptidase domain of ComA, designated PEP, was expressed as a soluble protein in Escherichia coli, purified to homogeneity, and characterized. Gel-filtration analysis revealed that PEP functions as a monomer. The purified PEP exhibited an efficient proteolytic activity for the substrate ComC, which was cleaved after the double glycine site. The stability of PEP was examined by circular dichroism analyses. A convenient method for analyzing the proteolytic activity of PEP was developed, and the kinetic parameters for ComC were determined (kcat = 1.5 ± 0.083 min–1 and Km = 62 ± 9.0 μm). Replacements of Cys17 of PEP with Ser or Ala and His96 with Ala resulted in complete loss of activity, indicating that both Cys17 and His96 are essential for the catalysis. Together with information from a protease data base, the N-terminal domain of ComA was concluded to belong to the same clan as the papain-like cysteine proteases. Mutant substrates, in which each of the double glycines was replaced with Ala, were cleaved very poorly by PEP. The mechanism of this strict substrate specificity is discussed on the basis of the sequence alignment with other cysteine proteases.