Miracle-dz/UniFAR-FTUs huggingface dataset:
Liver Failure After Transarterial Chemoembolization for Patients With Hepatocellular Carcinoma and Ascites: Incidence, Risk Factors, and Prognostic Prediction

Background Transarterial chemoembolization (TACE) is widely used in patients with hepatocellular carcinoma (HCC). Post-TACE liver failure may occur, especially in patients with poor hepatic reserve. Ascites is often present in patients with HCC with coexisting cirrhosis. This study investigated the incidence, risk factors, and prognostic predictors in patients with HCC and ascites receiving TACE. Methods A total of 614 patients with HCC were enrolled and analyzed. Liver failure was defined as an increase of serum bilirubin level (≥2.0 mg/dL), increasing or newly developed ascites, or hepatic encephalopathy within 2 weeks of TACE. Results Ascitesthat were present in 100 (16.2%) patients at study entry, independently predicted a poor prognosis in the Cox proportional hazard model [relative risk (RR)=1.75, P=0.004]. Post-TACE liver failure occurred in 17 (17.3%) of 98 patients with HCC who had ascites and long-term follow-up. Child-Turcotte-Pugh class B (odds ratio=10.1, P=0.038) and post-TACE gastrointestinal bleeding (odds ratio=10.86, P=0.006) were independent risk factors associated with liver failure in the multivariate analysis. Of the 17 patients with post-TACE liver failure, 16 (94%) died within the first year of treatment. Liver failure (RR: 2.13, P=0.029), serum &agr;-fetoprotein level >51 ng/mL (RR=2.0, P=0.013) and poor performance status (RR: 2.17, P=0.003) independently predicted a poor prognosis in patients with ascites receiving TACE. Conclusions Preexisting ascites increases the mortality in patients with HCC receiving TACE. In patients with HCC and ascites, Child-Turcotte-Pugh class B and gastrointestinal bleeding are associated with liver failure after TACE. Post-TACE liver failure is a common event and predicts a decreased survival in patients with HCC and ascites.
Prognostic Significant or Not? The Positive Circumferential Resection Margin in Esophageal Cancer: Impact on Local Recurrence and Overall Survival in Patients Without Neoadjuvant Treatment

Objective: The aim of this study is to investigate the impact of the circumferential resection margin (CRM) in esophageal cancer on survival and recurrence in patients without pretreatment. Background: Whereas the infiltration of the proximal or distal resection margin is associated with poor survival and higher recurrence, studies looking at the role of the circumferential resection margin on survival and local recurrence after esophagectomy are conflicting. Methods: Influence of CRM infiltration according to the College of American Pathologists (CAP) and Royal College of Pathologists (RCP) on long-term survival of 180 patients with resected pT3 tumors and without neoadjuvant therapy was analyzed. Results: A positive CRM was found in 76 (42.4%) patients according to RCP and 44 (24.4%) patients according to CAP. The CRM status had neither according to CAP nor according to RCP a significant impact on overall survival (P = 0.317 and 0.655, respectively), local recurrence (P = 0.716 and 0.900, respectively), or distant tumor relapse (P = 0.303 and 0.471, respectively). Lymphatic tumor spread found in 129 (71.7%) patients was an independent prognosticator (P = 0.002). In 137 (76.1%) patients who had a transthoracic esophagectomy a CRM infiltration was significantly lower according to CAP compared with 43 (23.9%) patients who had a transhiatal esophagectomy (P = 0.026). Conclusions: CRM was found to have no impact on survival and recurrence in esophageal cancer. Therefore, the possible impact of neoadjuvant pretreatment in locally advanced tumors should be considered with caution in terms of an improved resectability.
Endoluminal Aortic Grafting with Renal and Superior Mesenteric Artery Incorporation by Graft Fenestration

Purpose: To explore the use of juxta- and suprarenal aortic segments for endograft fixation in abdominal aortic aneurysm (AAA) patients and to develop methods of graft implantation that use endograft fenestrations to preserve renal and visceral vessel perfusion. Methods: From August 1998 to May 2000, 13 AAA patients with unsuitable infrarenal aortic necks were treated with custom-designed endovascular grafts employing the juxta- and suprarenal aortic segments for proximal sealing. Flow to 33 renal and superior mesenteric arteries was maintained via graft fenestrations that were aligned by use of radiopaque graft markers. The fenestration-orifice interface for renal arteries was secured with modified balloon-expandable stents. Results: All fenestrated grafts were deployed as planned, and all target vessels (33/33) were preserved. Two patients did not receive any stents, one being the first in the series and another who had incorporation of a renal accessory artery only. Without the use of transgraft stenting, 5 renal arteries would have been occluded by the endograft or poorly perfused. Procedural success was 100%. No conversion to open operation or graft-related complications occurred. There was no primary endoleak in any patient by angiographic criteria. Two patients required additional surgical procedures related to access vessels. Periprocedural mortality at 30 days was nil. Follow-up ranging from 3 to 24 months on all patients has not demonstrated any proximal or distal endoleaks. One stented renal vessel has occluded; all other arteries remain patent at last examination. Conclusions: This study has demonstrated the ability to successfully place a multifenestrated endoluminal graft in an aortic aneurysm using juxta- and suprarenal aortic segments to obtain a satisfactory seal. Stenting of the fenestration—renal ostium junction has helped to maintain renal patency.
THE EFFECT OF AMINOMETHYLPTEROYLGLUTAMIC ACID ON THE DEVELOPMENT OF SKIN HYPERSENSITIVITY AND ON ANTIBODY FORMATION IN GUINEA PIGS

1. In guinea pigs, aminomethylpteroylglutamic acid (methotrexate) is capable of blocking the development of delayed skin hypersensitivity, the primary antibody response, and the specific febrile response to ovalbumin and diphtheria toxoid. The primary antibody response is more easily inhibited than is the development of delayed skin hypersensitivity. 2. The effect of methotrexate on immunologic responses depended upon the dose of methotrexate employed and the strength of the antigenic stimulus.
Sociosexuality from Argentina to Zimbabwe: A 48-nation study of sex, culture, and strategies of human mating

The Sociosexual Orientation Inventory (SOI; Simpson & Gangestad 1991) is a self-report measure of individual differences in human mating strategies. Low SOI scores signify that a person is sociosexually restricted, or follows a more monogamous mating strategy. High SOI scores indicate that an individual is unrestricted, or has a more promiscuous mating strategy. As part of the International Sexuality Description Project (ISDP), the SOI was translated from English into 25 additional languages and administered to a total sample of 14,059 people across 48 nations. Responses to the SOI were used to address four main issues. First, the psychometric properties of the SOI were examined in cross-cultural perspective. The SOI possessed adequate reliability and validity both within and across a diverse range of modern cultures. Second, theories concerning the systematic distribution of sociosexuality across cultures were evaluated. Both operational sex ratios and reproductively demanding environments related in evolutionary-predicted ways to national levels of sociosexuality. Third, sex differences in sociosexuality were generally large and demonstrated cross-cultural universality across the 48 nations of the ISDP, confirming several evolutionary theories of human mating. Fourth, sex differences in sociosexuality were significantly larger when reproductive environments were demanding but were reduced to more moderate levels in cultures with more political and economic gender equality. Implications for evolutionary and social role theories of human sexuality are discussed.
How Homeless Sector Workers Deal with the Death of Service Users: A Grounded Theory Study

Homeless sector workers often encounter the deaths of service users. A modified grounded theory methodology project was used to explore how workers make sense of, respond to, and cope with sudden death. In-depth interviews were undertaken with 16 paid homeless sector workers who had experienced the death of someone with whom they worked. Transcripts of interviews and field notes were analyzed using the constant comparative method and a theory that described the positive framing of death emerged. Dealing with death and trauma is not something that most workers expect when they begin work but exposure to the death of a service user heightens expectations that other service users may be harmed. How workers cope or positively frame death depends on several interlinked processes. These include how the death is encountered; how the worker and others mark the death; and the extent that the vulnerability of self, peers, and service users is recognized and responded to. Successfully framing death enables the worker to continue working in the sector whilst maintaining enthusiasm for the work and compassion for service users.
Reference broadcast synchronization scheme for nanomachines

Nanomachine is a kind of nanoscale device, with the size ranging from one to a hundred nanometers. The nanomachines exchange information with each other by molecular communication, which is a novel bio-inspired communication technology. The synchronization among the nanomachines is important for a lot of applications in the development of instrumentation and measurement technologies at nanoscale. In this paper, a reference broadcast synchronization scheme for the nanomachines is proposed. In this scheme, a reference nanomachine sends a beacon to its child nanomachines. The child nanomachines exchange information to achieve the synchronization. The Gaussian distribution is used to model the molecular propagation delay between the nanomachines. The relative clock offset and the relative clock skew are estimated by joint maximum likelihood estimation. The simulation results demonstrate that the proposed synchronization scheme is effective.
Clinical course of subepithelial lesions detected on upper gastrointestinal endoscopy.

AIM To evaluate the natural history of subepithelial lesions. METHODS We reviewed the medical records of 104159 patients who underwent upper gastrointestinal endoscopy at the Center for Health Promotion of Samsung Medical Center between 1996 and 2003. Subepithelial lesions were detected in 795 patients (0.76%); 252 patients were followed using upper gastrointestinal endoscopy for 82.5 +/- 29.2 mo (range, 12-160 mo; median, 84 mo; 1st quartile, 60 mo; 3rd quartile, 105 mo). The median interval of follow-up endoscopy was 12 mo (range, 6-105 mo; 1st quartile, 12 mo; 3rd quartile, 24 mo). RESULTS The mean patient age was 53 years (range, 22-80 years), and the male-to-female ratio was 2.36:1 (177/75). The lesion size at initial measurement averaged 8.9 mm (range, 2-25 mm; median, 8 mm; 1st quartile, 5 mm; 3rd quartile, 10 mm). Of the 252 lesions, 244 (96.8%) were unchanged and 8 (3.2%) were significantly increased in size (from 12.9 +/- 6.0 to 21.2 +/- 12.2 mm) after a mean interval of 59.1 +/- 27.5 mo (range, 12-86 mo). Surgical resection of lesions was performed when the lesions were > or = 3 cm in diameter. Two lesions were diagnosed as gastrointestinal stromal tumors with an intermediate or high risk of malignancy and one lesion was classified as a schwannoma. CONCLUSION Most small subepithelial lesions do not change as shown by endoscopic examination, and regular follow-up with endoscopy may be considered in small, subepithelial lesions, especially lesions < 1 cm in size.
An X‐ray diffraction study of model membrane raft structures

Protein sorting and assembly in membrane biogenesis and function involves the creation of ordered domains of lipids known as membrane rafts. The rafts are comprised of all the major classes of lipids, including glycerophospholipids, sphingolipids and sterol. Cholesterol is known to interact with sphingomyelin to form a liquid‐ordered bilayer phase. Domains formed by sphingomyelin and cholesterol, however, represent relatively small proportions of the lipids found in membrane rafts and the properties of other raft lipids are not well characterized. We examined the structure of lipid bilayers comprised of aqueous dispersions of ternary mixtures of phosphatidylcholines and sphingomyelins from tissue extracts and cholesterol using synchrotron X‐ray powder diffraction methods. Analysis of the Bragg reflections using peak‐fitting methods enables the distinction of three coexisting bilayer structures: (a) a quasicrystalline structure comprised of equimolar proportions of phosphatidylcholine and sphingomyelin, (b) a liquid‐ordered bilayer of phospholipid and cholesterol, and (c) fluid phospholipid bilayers. The structures have been assigned on the basis of lamellar repeat spacings, relative scattering intensities and bilayer thickness of binary and ternary lipid mixtures of varying composition subjected to thermal scans between 20 and 50 °C. The results suggest that the order created by the quasicrystalline phase may provide an appropriate scaffold for the organization and assembly of raft proteins on both sides of the membrane. Co‐existing liquid‐ordered structures comprised of phospholipid and cholesterol provides an additional membrane environment for assembly of different raft proteins.
Effectiveness of relaxation for postoperative pain and anxiety: randomized controlled trial.

AIM This paper is a report of a study to determine the effectiveness of jaw and total body relaxation for postoperative pain, anxiety and level of relaxation, and to determine any patient expectancy effects. BACKGROUND Relaxation is increasingly suggested as a pain control technique that can be used by nurses in daily practice. A systematic review of the effectiveness of relaxation for postoperative pain relief revealed many poorly designed studies and only some weak evidence supporting the use of relaxation for postoperative pain. METHOD A randomized controlled trial (n = 118) was conducted between 2002 and 2003 to compare total body relaxation, jaw relaxation, attention control and usual care. Consenting patients admitted for elective orthopaedic surgery aged 18 or over, able to speak English and able to tense and relax more than two muscle groups were included. Pain at rest and on movement, anxiety and relaxation were assessed at pre-admission clinic, pre-intervention, immediately post-intervention and 1, 2, 3 and 4 hours later. However, the trial was under-powered. FINDINGS There were statistically significant reductions in pain at rest from pre- to post-intervention for both the relaxation groups and the attention control group. The usual care group had a small increase in pain, whilst the other three groups had similar small decreases in pain. There was no statistically significant difference in anxiety or relaxation scores pre- to post-intervention between groups. CONCLUSION Jaw relaxation could give these orthopaedic patients a small, very short-lasting additional amount of pain relief, and it may be that staff and patients feel this small benefit to be worthwhile.
Confirmation and Fine Mapping of Ethanol Sensitivity Quantitative Trait Loci, and Candidate Gene Testing in the LXS Recombinant Inbred Mice

In previous studies, we have mapped quantitative trait loci (QTLs) for hypnotic sensitivity to ethanol using a small recombinant inbred (RI) panel and a large F2 backcross. Alcohol sensitivity is a major predictor of long-term risk for alcoholism. We remapped hypnotic sensitivity using a new set of 75 RI strains, the LXS, derived from Inbred Long Sleep and Inbred Short Sleep strains. We expected to improve mapping resolution in the QTL regions and to identify novel QTLs for loss of the righting reflex due to ethanol. We used three common mapping algorithms (R/qtl, QTL Cartographer, and WebQTL) to map QTLs in the LXS, and we compared the results. Most mapping studies use only a single algorithm, an approach that may result in failure to identify minor QTLs. We confirmed most of our previously reported QTLs, although one major QTL from earlier work (Lore2) failed to replicate, possibly because it represented multiple linked genes separated by recombination in the RI strains. We also report narrowed confidence intervals, based on mapping with a new genetic resource of more than 4000 polymorphic single-nucleotide polymorphism markers. These narrowed confidence intervals will facilitate candidate gene identification and assessment of overlap with human regions specifying risk for alcoholism. Finally, we present an approach for using these RI strains to assess evidence for candidate genes in the narrowed intervals, and we apply this method to a strong candidate, the serotonin transporter.
Interleukin‐12 profoundly up‐regulates the synthesis of antigen‐specific complement‐fixing IgG2a, IgG2b and IgG3 antibody subclasses in vivo

The influence of the cytokine interleukin‐12 (IL‐12) on humoral immune responses was studied in vivo. CBA/J mice immunized with protein antigens (keyhole limpet hemocyanin, phospholipase A2) adsorbed to aluminum hydroxide (Alum) develop a Th2‐like immune response characterized by the production of large amounts of IgG1 as well as some IgE but little IgG2a, IgG2b and IgG3 antibodies. IL‐12 is a cytokine that promotes the development and the activation of Th1 cells. Th1 cells are involved in the induction of cellular immunity, which is characterized by low or absent antibody production. On the other hand, some Th1‐like immune responses are associated with a strong antibody production of the IgG2a, IgG2b and IgG3 subclasses. Thus, we investigated whether treatment with IL‐12 would down‐regulate the humoral immune response or stimulate antibody production of the IgG2a, IgG2b and IgG3 subclasses. We observed that: 1) administration of IL‐12 to mice together with protein antigens adsorbed to Alum strongly enhanced the humoral immune response by increasing the synthesis of antigen‐specific antibodies of the IgG2a, IgG2b and IgG3 subclasses 10‐ to 1000‐fold. The synthesis of IgG1 was not or only slightly (2–5‐fold) enhanced, whereas that of the IgE isotype was suppressed. 2) These effects of IL‐12 were observed when high (10 μg, 100 μg) or low doses (0.1 μg) of antigen were used for immunization. 3) Titration of IL‐12 in vitro revealed that IgG2a is strongly up‐regulated over a wide dose range of IL‐12 (10 to 1000 ng/day). 4) The effects of IL‐12 in vivo are at least partially interferon (IFN)‐γ‐dependent because an anti‐IFN‐γ mAb in combination with IL‐12 prevented most of the enhanced IgG2a production. 5) Mice receiving IL‐12 showed a strong up‐regulation of IFN‐γ but no inhibition of IL‐5 synthesis by spleen cells activated ex vivo with antigen. These results suggest that IL‐12 is a potent adjuvant for enhancing humoral immunity to protein antigens adsorbed to Alum, primarily by inducing the synthesis of the complement‐fixing IgG subclasses 2a, 2b and 3.
Does Training Spare Insulin Secretion and Diminish Glucose Levels in Real Life?

Compared with untrained subjects, in trained subjects the increased insulin sensitivity and decreased glucose induced insulin secretion will tend to promote health by decreasing glucose levels and insulin secretion, whereas the increased food intake will tend to increase these variables. To evaluate the net effect of training, we administered oral glucose loads making up identical fractions of daily carbohydrate intake (i.e., same relative glucose loads) to 8 athletes and 7 sedentary subjects (age: 25 ± 1 vs. 24 ± 1 yr [mean ± SE] [NS]; body weight: 76.0 ± 1.3 vs. 79.3 ± 2.3 kg [NS]; maximal oxygen uptake: 76 ± 2 vs. 48 ± 1 ml O2 · kg−1 · min−1 [2P < 0.05], respectively). Furthermore, 24 h plasma concentration profiles of glucose, C-peptide, and insulin were determined during ordinary living conditions. Daily carbohydrate intake was higher (2P < 0.05) in athletes compared with sedentary subjects (678 ± 34 vs. 294 ± 18 g · day−1, respectively). In response to same relative oral glucose loads, glucose and C-peptide responses were similar in athletes compared to sedentary subjects. Twenty-four hour integrated glucose and C-peptide concentrations did not differ between athletes and sedentary subjects (7.4 ± 0.2 vs. 7.3 ± 0.6 mol · L−1 · 1440 min [2P > 0.05] and 923 ± 99 vs. 1047 ± 175 pM · ml−1 · 1440 min [2P > 0.05], respectively), and insulin concentrations tended to be lower in athletes compared with sedentary subjects (124 ± 13 vs. 175 ± 38 pM · ml−1 · 1440 min [2P > 0.05]). It is concluded that, during training, adaptations in pancreas and insulin sensitive tissues allow the necessary increase in food intake without harmful hyperglycemia and overloading of (β-cells, but sparing of insulin secretion and reductions in glucose levels are only relative to food intake. However, training may be wholesome by increasing hepatic insulin extraction and thereby decreasing arterialinsulin levels.
More than half of senior residents in Tehran have never heard about colorectal cancer screening.

BACKGROUND Colorectal cancer (CRC) is the third most prevalent malignancy in Iran. Although adequate knowledge about CRC and screening tests has a significant effect on screening behavior, there is still no clear information in this regard in Iran. The aim of the study was therefore to identify knowledge toward CRC and obstacles to screening tests among an Iranian population. METHODS We conducted a preliminary analysis with baseline data drawn from an ongoing randomized community trial among people aged 50 years and over in municipal district 6 in Tehran. A total of 360 members of health houses, who were not being exposed to CRC screening tests, completed the baseline survey and randomized to two study groups. Data were collected via personal interviews by 12 trained interviewers for demographics, knowledge related to CRC, and barriers to screening tests. RESULTS The mean age was 58.0 (± 7.13) ranging from 50 to 86 years; 69% were female, 52% were unemployed, 65% had completed high school, and 90% had medical insurance. A considerable number of respondents stated that they had never heard about fecal occult blood test (61%) and colonoscopy (51%) as CRC screening tests. In general, participants were more likely to respond the knowledge items inaccurately. Four commonly stated reasons for not being screened were "absence of clinical symptoms" (29%); "doctor did not recommend the test" (26%); "never think of the test" (22%); and "did not think it was needed" (11%). CONCLUSION Our findings indicated that lack of knowledge about CRC and various barriers to screening tests exist among Iranians. Our results may facilitate the development of effective educational strategies primarily aimed at high-risk people.