Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of surgery in metastatic pancreatic neuroendocrine tumors: a competing risk analysis

Aim The role of surgery in the treatment of metastatic pancreatic neuroendocrine tumors (PNETs) was controversial. The objectives of this study were to illustrate the impact of surgery in improving the prognosis of patients with metastatic PNETs and build nomograms to predict overall survival (OS) and cancer-specific survival (CSS) based on a large population-based cohort. Methods Patients diagnosed with metastatic PNETs between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were retrospectively collected. Nomograms for estimating OS and CSS were established based on Cox regression model and Fine and Grey’s model. The precision of the nomograms was evaluated and compared using concordance index (C-index) and the area under receiver operating characteristic (ROC) curve (AUC). Results The study cohort included 1966 patients with metastatic PNETs. It was shown that the surgery provided survival benefit for all groups of patients with metastatic PNETs. In the whole study cohort, 1-, 2- and 3-year OS and CSS were 51.5, 37.1 and 29.4% and 53.0, 38.9 and 31.1%, respectively. The established nomograms were well calibrated, and had good discriminative ability, with C-indexes of 0.773 for OS prediction and 0.774 for CSS prediction. Conclusions Patients with metastatic PNETs could benefit from surgery when the surgery tolerance was acceptable. The established nomograms could stratify patients who were categorized as tumor-node-metastasis (TNM) IV stage into groups with diverse prognoses, showing better discrimination and calibration of the established nomograms, compared with 8th TNM stage system in predicting OS and CSS for patients with metastatic PNETs.
Effects of alcohol and tramadol co-treatment on cognitive functions and neuro-inflammatory responses in the medial prefrontal cortex of juvenile male rats

Objectives: Misuse and abuse of drugs are on the increase amongst juvenile individuals across the world. This study was carried out to evaluate the cognitive and subcellular neuropathologic events in the medial prefrontal cortex (mPFC) of juvenile male rats following exposure to alcohol and tramadol hydrochloride. Methods: The rats were assigned into four groups; vehicle group, alcohol group, tramadol group, and the alcohol+tramadol combined group. Twenty-four hours after the administration of the last dose, 5 rats from each group were sacrificed. The mPFCs were excised and were stained with either cresyl violet or glia fibrillary acidic protein immunoreactivity. The remaining rats in each of the groups were subjected to cognitive behavioural tests. Results: The administration of alcohol, tramadol and the co-administration of alcohol+tramadol triggers astrogliosis, glial scars and inflammatory responses relative to the vehicle-treated with well-preserved profile. The distribution of Nissl substances suggested that the neurons are either undergoing neurodegeneration or neuronal metabolism impairment. The behavioural tests showed that the administration of the respective substances impaired cognition in the treated rats compared to the vehicle-treated rats. Conclusion: This study concluded that alcohol, tramadol, and alcohol+tramadol misuse can impair the functional integrity of the medial prefrontal cortex.
PREDICTORS OF OVERWEIGHT AND OBESITY AMONG SECONDARY SCHOOL STUDENTS IN PUCHONG SELANGOR, MALAYSIA

Background: Childhood obesity is gaining a dramatic increase in developing as well as in developed countries. Childhood overweight and obesity in which adolescents are included have be known to have negative impact on both physical and psychological health. Overweight and obese children are likely to stay obese into their adulthood and are more likely to develop non-communicable diseases . The objective of this study is to determine the occurrence and factors associated with overweight and obesity among secondary school students in Puchong Selangor Malaysia. Materials and Method: A cross-sectional study design was employed. A self-constructed pretested questionnaire was used for the data collection. The questionnaire consists of six sections, which include: socio-demography characteristics, physical activity questionnaire, self-esteem scale, body parts satisfaction scale, body size perception scale and smoking status questionnaire. Weight and height were measured and converted to body mass index (BMI). The study analysis was done using SPSS version 22. Basic descriptive analyses were carried out for the mean, median, frequency and percentage. Chi square test was used to test association between the variables. Multiple logistic regressions were used to determine the predictors of overweight and obesity among the respondents. Result: The response rate was 100%. The respondents’ age was 13-17years and occurrence of overweight and obesity was 10% and 3.9% respectively. Out of the 281 students that participated in the study 164 were female (58.4%). Overweight and obesity was significantly associated with father’s education ( χ2 = 9.697, df= 2, p =0.006), mothers education ( χ2 = 7.448, df= 2, p = 0.023), body part satisfaction ( χ2 =14.837, df= 1, p = 0.001) and body image ( χ2 =6.745, df= 1, p = 0.009). Multiple logistic regression analysis showed that the predictors of obesity were age (AOR=2.049, 95% CL: 0.186, 0.835, p <0.007), body parts satisfaction (AOR=3.656, 95% CL: 1.729, 7.730, p <0.001) and body size perception (AOR=3.130, 95%:1.269, 7.718, p <0.014). Conclusion: The significant predictors of overweight and obesity among study population were age, body parts satisfaction and body size perception. Keywords: Overweight, obesity, association, predictors, secondary school, students.
Effects of Multiple Nonnative Fish on an Imperiled Cyprinid, Hornyhead Chub

Nonnative fish can have substantial negative effects on the abundance and distribution of native fishes through predation and competition. Nonnative predators are of particular interest because they represent novel threats to native prey species that are not adapted to their presence. Prey species with limited distributions or population sizes may be particularly vulnerable to the effects of nonnative predators. In the Laramie River, four nonnative predators—Brown Trout Salmo trutta, Rainbow Trout Oncorhynchus mykiss, Brook Trout Salvelinus fontinalis, and Smallmouth Bass Micropterus dolomieu are present along with a state-imperiled population of Hornyhead Chub Nocomis biguttatus. The abundance of Hornyhead Chub has declined with increasing abundance of nonnative predators, with the probability of occurrence of Hornyhead Chub dropping drastically when Smallmouth Bass were present. All four nonnative species preyed on native cyprinids, but Smallmouth Bass relied most heavily on fish as a prey item. Isotopic niche overlap occurred between Hornyhead Chub and all of the nonnative predator species. Our results demonstrate that nonnative predators have the potential to negatively affect the abundance and distribution of Hornyhead Chub through the mechanisms of predation and competition, and predator identity is important in determining the extent of effects. Smallmouth Bass are a greater concern than nonnative salmonids because of their more piscivorous behavior, and their recent upstream expansion may be limiting the downstream distribution of Hornyhead Chub in the Laramie River. Interactions between predator and prey species play an important role in structuring aquatic communities (Hoeinghaus and Pelicice 2010; Cucherousset and Olden 2011). Piscivorous fishes can cause declines in the abundance and distribution of prey species through direct predation (Garman and Nielsen 1982; Kershner and Lodge 1995; Jackson et al. 2001) or through competitive interactions for space or resources (Mills et al. 2004). Assessing the relative importance of competitive versus predatory interactions in driving changes in the abundance of prey species is difficult (Crowder 1980; Ross 2013), but understanding the importance of these drivers is critical to the effective management of fisheries resources, particularly in contemporary ecosystems with nonnative species. *Corresponding author: bhicker1@uwyo.edu Received June 27, 2019; accepted September 4, 2019 Transactions of the American Fisheries Society © 2019 American Fisheries Society ISSN: 0002-8487 print / 1548-8659 online DOI: 10.1002/tafs.10203
Relationship between arterial stiffness and unattended or attended blood pressure values.

BACKGROUND AND METHOD Measurement of 'unattended' blood pressure (BP) may reduce or eliminate the 'white-coat effect'. Despite the possible advantages of this approach for BP measurement, only few studies analysed the relationship between unattended BP and cardiovascular events or with hypertension-mediated organ damage (HMOD). The aim of our study was to evaluate the relationship between 'attended' or 'unattended' BP values and carotid-femoral pulse wave velocity (PWV) in 285 individuals undergoing a visit and assessment of arterial stiffness at an ESH Excellence Centre. Unattended BP (measured with the patient alone in the room, with an oscillometric device programmed to perform three BP measurements, at 1-min intervals, after 5 min) and attended BP were measured with the same device, on the same day of the measurement of PWV, in a random order. RESULTS Mean age was 63 ± 13 years, mean BMI 26 ± 4, 47% were women, 76% had hypertension (55% treated). Systolic unattended BP was lower than attended SBP (124.4 ± 14.3 vs. 130.9 ± 16.1 mmHg). PWV was similarly correlated with attended and unattended SBP values (r = 0.428 and r = 0.404, P < 0.0001, respectively). No difference for the prediction of increased arterial stiffness was observed at receiver operator curves (ROCs) analysis [attended SBP area under the curve (AUC) 0.665, 95% confidence interval (95% CI) 0.607-0.720 vs. unattended SBP: AUC 0.651, 95% CI 0.593-0.706, P for the comparison = ns]. CONCLUSION Attended and unattended BP values are similarly correlated with PWV, the gold standard measure of arterial stiffness. These findings may provide further information on the clinical value of unattended BP.
Gender disadvantage as a risk factor for common mental disorder in women residing in Rawalpindi/Islamabad

I assessed common mental disorder (CMD) and its association with gender disadvantage among young women in two defined catchment areas (with contrasting socio-economic circumstances) in each city. Socio-economic status is a risk factor for CMD, and may confound or modify the effect of gender disadvantage, hence the stratified sampling. Female gender disadvantage cannot be measured directly, but is a well recognized phenomenon and has important effects across the life course. I used five proxy indicators; 1) no older brother at the time of birth (as a proxy for male preference), 2) limited parental bonding (low care and high overprotection), 3) low educational attainment 4) adverse marital circumstances (early age at marriage and low satisfaction) and 5) subjective perception. Recruitment and interviewing of 525 women aged 20-35 was completed with 98% response rate. 57% were married. The prevalence of CMD (SRQ score >=8) ranged from 26% (high SES Rawalpindi) to 83% (low SES Islamabad). Perception of parental preference for males, low care, less education, early age at marriage and low marital satisfaction were, as hypothesized, strongly correlated. I have found strong effects of all of the indicators of gender disadvantage (other than birth order) upon risk for CMD, independent of SES. I found strong evidence to support the main hypothesis of an independent association between low care and increased risk for CMD. However, for this risk factor the effect was modified by SES being significantly stronger among those living in higher SES districts.
The effect of transportation modality to dialysis facilities on health-related quality of life among hemodialysis patients: results from the Japanese Dialysis Outcomes and Practice Pattern Study

Abstract Background For hemodialysis (HD) patients, travel to the dialysis facility is an issue that can affect their quality of life (QOL), both physically and mentally. However, evidence on this association of transportation modality with health-related QOL (HRQOL) is scarce. Methods We conducted a cohort study among maintenance HD patients participating in the Japanese Dialysis Outcomes and Practice Pattern Study Phase 5. The study included patients who were functionally independent and able to walk. The primary exposure was the means of transportation to the dialysis facility, categorized into three groups, namely transportation by other drivers (Group 1), transportation via self-driving (Group 2) and transportation by bicycle or walking with or without public transportation (Group 3). The primary outcomes were physical and mental health composite scores (PCS and MCS) in the 12-item Short Form at 1 year after study initiation. Results Among 1225 eligible patients (Group 1, 34.4%; Group 2, 45.0%; Group 3, 20.7%), 835 were analyzed for the primary outcomes. Linear regression analyses revealed that patients in Groups 2 and 3 had significantly higher PCS and MCS at 1 year than those in Group 1 {adjusted mean differences of PCS 1.42 [95% confidence interval (CI) 0.17–2.68] and 1.94 [95% CI 0.65–3.23], respectively, and adjusted mean differences of MCS 2.53 [95% CI 0.92–4.14] and 2.20 [95% CI 0.45–3.95], respectively}. Conclusions Transportation modality was a significant prognostic factor for both PCS and MCS after 1 year in maintenance HD patients.
Modelling risk in healthcare based on simulation of episodes of interactions relating to patient care

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Public Perceptions on Breast Implant–associated Anaplastic Large Cell Lymphoma

Background: Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) has entered the spotlight, as several high-profile media outlets have begun to relay the evolving science to the public. This study aimed to gauge the baseline knowledge and concern regarding BIA-ALCL among adult laywomen within the United States. Methods: Mechanical Turk was used to survey 500 American women on self-reported demographics, prior experience with breast implants, and 11 questions regarding their knowledge and concern regarding BIA-ALCL. Responses were reviewed for quality control before study inclusion. Results: Overall, 12 percent of respondents had received breast implants and 73 percent knew someone with implants; 13.6 percent of respondents (including 51.7 percent of respondents with implants) had previously heard of BIA-ALCL. After providing information about its risk, 58.4 percent of respondents were still willing to receive a reconstructive implant and 45.8 percent a cosmetic implant; 35.8 percent reported they would be less likely to receive an implant. Of the respondents with breast implants, 66.7 percent reported some degree of concern regarding BIA-ALCL and 35.0 percent are strongly considering removing their implants. Those who had heard of BIA-ALCL consumed information from several sources, predominantly health professionals or media/health care blogs. Different sources of information were not associated with a respondent’s degree of concern. Conclusions: Only a minority of American women have heard of BIA-ALCL and understand its association with breast implants. As plastic surgeons who perform breast reconstruction, we can promote the spread of information through the popular media and health care blogs to address this growing concern, particularly among women with existing breast implants.
Interaction between Mesenchymal Stem Cells and Intervertebral Disc Microenvironment: From Cell Therapy to Tissue Engineering

Low back pain (LBP) in one of the most disabling symptoms affecting nearly 80% of the population worldwide. Its primary cause seems to be intervertebral disc degeneration (IDD): a chronic and progressive process characterized by loss of viable cells and extracellular matrix (ECM) breakdown within the intervertebral disc (IVD) especially in its inner region, the nucleus pulposus (NP). Over the last decades, innovative biological treatments have been investigated in order to restore the original healthy IVD environment and achieve disc regeneration. Mesenchymal stem cells (MSCs) have been widely exploited in regenerative medicine for their capacity to be easily harvested and be able to differentiate along the osteogenic, chondrogenic, and adipogenic lineages and to secrete a wide range of trophic factors that promote tissue homeostasis along with immunomodulation and anti-inflammation. Several in vitro and preclinical studies have demonstrated that MSCs are able to acquire a NP cell-like phenotype and to synthesize structural components of the ECM as well as trophic and anti-inflammatory mediators that may support resident cell activity. However, due to its unique anatomical location and function, the IVD presents distinctive features: avascularity, hypoxia, low glucose concentration, low pH, hyperosmolarity, and mechanical loading. Such conditions establish a hostile microenvironment for both resident and exogenously administered cells, which limited the efficacy of intradiscal cell therapy in diverse investigations. This review is aimed at describing the characteristics of the healthy and degenerated IVD microenvironment and how such features influence both resident cells and MSC viability and biological activity. Furthermore, we focused on how recent research has tried to overcome the obstacles coming from the IVD microenvironment by developing innovative cell therapies and functionalized bioscaffolds.
Solitary Nodular Invasive Mucinous Adenocarcinoma of the Lung: Imaging Diagnosis Using the Morphologic-Metabolic Dissociation Sign

Objective To evaluate the efficacy of the morphologic-metabolic (M-M) dissociation sign based on computed tomography (CT) and fluorine-18-fluorodeoxyglucose positron emission tomography (PET)/CT in discriminating invasive mucinous adenocarcinoma (IMA) from invasive non-mucinous adenocarcinomas (ADCs) of the lung. Materials and Methods The Institutional Review Board approved this retrospective study. Among surgically resected solitary pulmonary nodule (SPN)-type ADCs (< 3 cm in diameter), 35 patients with IMAs and 329 with invasive non-mucinous ADCs were included. Morphologic malignancy was established if the tumor with lobulated or spiculated margin on CT presented a tumor shadow disappearance rate of < 0.5. The M-M dissociation sign was determined when a malignant-morphologic nodule on CT showed maximum standardized uptake value (SUVmax) < 3.5 on PET/CT. Results Among 35 IMAs (size: 21 ± 7 mm, SUVmax: 1.8 ± 2.0) and 329 invasive non-mucinous ADCs (size: 21 ± 6 mm, SUVmax: 4.6 ± 4.2), the M-M dissociation sign was observed in 54% of IMAs (19/35) and 10% of invasive non-mucinous ADCs (34/329) (p < 0.001). The diagnostic performance of the sign in discriminating IMA from invasive non-mucinous ADCs showed a sensitivity of 54.3% (95% confidence interval [CI], 36.7–71.2), specificity 89.7% (95% CI, 85.9–92.7), positive predictive value 35.8% (95% CI, 26.5–46.5), and negative predictive value 94.9% (95% CI, 92.8–96.4). Multivariate analyses revealed metabolic benignity (odds ratio [OR] 2.99; 95% CI, 1.01–8.93; p = 0.047) and M-M dissociation sign (OR 6.35; 95% CI, 2.76–14.62; p < 0.001) to be significant predictors of SPN-type IMAs. Conclusion Identification of the absence of M-M dissociation sign is an accurate indicator for excluding IMA from SPN-type lung ADCs.
Vestibular functioning and pathology in adults with HIV/AIDS : a comparative study

Introduction: Disorders of the auditory and vestibular system are often associated with HIV/AIDS. However, the extent and nature of these vestibular manifestations are unclear. Objective: To systematically review the current peer-reviewed literature on vestibular vestibular manifestations and pathology related to HIV/AIDS. Method: Systematic review of peer-reviewed articles, related to vestibular findings in individuals with HIV/AIDS. Several electronic databases were searched. Results: We identified 442 records reduced to 210 after excluding duplicates and reviews. These were reviewed for relevance to the scope of the study. Discussion: We identified only 13 reports investigating the vestibular functioning and pathology in individuals infected with HIV/AIDS. This condition can affect both the peripheral and central vestibular system, irrespective of age and viral disease stage. Peripheral vestibular involvement may affect up to 50% of patients and central vestibular involvement may be even more prevalent. Postmortem studies suggest direct involvement of the entire vestibular system, while opportunistic infections such as otoand neurosyphilis and encephalitis cause secondary vestibular dysfunction resulting in vertigo/dizziness and disquilibrium. © University of Pretoria Page | 83 Conclusion: Patients with HIV/AIDS should routinely be monitored for vestibular involvement to minimize functional limitations on quality of life. © University of Pretoria Page | 84 4.
Disruption of NOX2-dependent Oxidative Injury with a Targeted Gene-Therapy Approach Prevents Atrial Fibrillation in a Canine Model

Atrial fibrillation is the most common heart rhythm disorder in adults and a major cause of stroke. Unfortunately, current treatments of AF are suboptimal as they are not targeted to the molecular mechanisms underlying AF. In this study, we demonstrated using a novel gene-based strategy in a clinically relevant large animal of AF that oxidative injury is a key mechanism underlying the onset and perpetuation of AF. First, we demonstrated that generation of oxidative injury in atrial myocytes is a frequency-dependent process, with rapid pacing in canine atrial myocytes inducing oxidative injury through induction of NADPH oxidase 2 (NOX2) and generation of mitochondrial reactive oxygen species. We show that oxidative injury likely contributes to electrical remodeling in AF by upregulating a constitutively active form of acetylcholine-dependent K+ current (IKACh) – called IKH - by a mechanism involving frequency-dependent activation of protein kinase C epsilon (PKCε). To understand the mechanism by which oxidative injury promotes the genesis and/or maintenance of AF, we performed targeted injection of NOX2 shRNA in atria of normal dogs followed by rapid atrial pacing. The time to onset of non-sustained AF increased by more than 5-fold in NOX2 shRNA treated dogs. Furthermore, animals treated with NOX2 shRNA did not develop sustained AF for up to 12 weeks. The electrophysiological mechanism underlying AF prevention was prolongation of atrial effective refractory periods, with attenuated activation of PKCε, a likely molecular mechanism underlying this beneficial electrophysiological remodeling. Future optimization of this approach may lead to a novel, mechanism-guided therapy for AF. One Sentence Summary Targeted disruption of NOX2-dependent oxidative injury with a novel gene therapy approach prevents onset as well as perpetuation of atrial fibrillation.