Miracle-dz/UniFAR-FTUs huggingface dataset:
Pertuzumab for the treatment of breast cancer: a safety review

ABSTRACT Introduction: Approximately twenty to thirty percent of newly diagnosed breast cancers are human epidermal growth factor receptor 2 (HER2) positive. The use of trastuzumab, and more recently pertuzumab, has significantly improved the progression free survival (PFS) and overall survival (OS) in this patient population. However, pertuzumab has side effects that can impact treatment tolerability and quality of life. Areas covered: This review describes the safety and tolerability of pertuzumab, a monoclonal antibody targeted at HER2 approved by the United States Food and Drug Administration (FDA) for use in the neoadjuvant and first line metastatic settings. Expert opinion: The combination of trastuzumab, pertuzumab, and chemotherapy is approved in the neoadjuvant and first line metastatic settings and should be strongly considered by providers. Further studies are needed to look at side effect prevention, novel pertuzumab containing regimens, and re-treating patients with pertuzumab.
Agglomeration and Spatial Spillover Effects of Regional Economic Growth in China

As the processes of globalization and localization deepen, spatial externalities of economic growth are becoming increasingly apparent. The agglomeration mechanisms and spillover effects of China’s regional economic growth are also gradually gaining attention. Nevertheless, there is a continuing lack of research at the prefecture and county levels. As a result, building on the foundations of new economic geography and centered on the concept of market potential, this paper used spatial econometrics and panel data from Chinese counties to calculate inequality in the economic growth of counties at the prefecture level for the period 1992–2013. It also investigated the agglomeration versus economic inequality trade-off as well as quantitatively measuring spatial spillover effects at the county and prefecture level in China. The results showed that economic agglomeration, represented by market potential, had a significant influence on economic growth at the prefecture level in China. In addition, economic agglomeration exacerbated regional economic inequality, but economic inequality within a controllable range was found to have a positive influence on economic growth. Thus, there is a trade-off between economic growth and economic agglomeration. Economic growth at the prefecture level in China is not yet free of the effects of basic factors of production, and direct spillover effects, represented by market potential, have the most significant and strongest positive influence on economic growth. Moreover, it was found that the economic growth of prefectures was inseparable from the random impacts of surrounding prefectures and that it was also affected by indirect spatial spillover effects. On the whole, the rational use of the benefits of regional economic agglomeration and spillover effects, the gradual removal of market barriers, and the transformation of the development of prefecture-level economic growth will be the keys to prefecture-level economic development in the future.
Vascular endothelial growth factor A (VEGFA) polymorphisms in Chinese patients with rheumatoid arthritis

Objectives: Vascular endothelial growth factor A (VEGFA) is the most potent proangiogenic molecule promoting the angiogenic phenotype of rheumatoid arthritis (RA). We hypothesized that VEGFA polymorphisms may contribute to RA susceptibility. Method: We studied VEGFA rs699947 C/A, rs2010963 G/C, and rs3025039 C/T gene polymorphisms in 329 patients with RA and 697 controls in a Chinese population. Genotyping was performed using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Results: VEGFA rs699947 C/A, rs2010963 G/C, and rs3025039 C/T polymorphisms were not associated with the risk of RA. However, in the dominant genetic model, a significantly decreased risk for RA associated with the VEGFA rs699947 CA/AA genotypes was evident among older patients and anti-cyclic citrullinated peptide antibody (ACPA)-negative patients compared with the VEGFA rs699947 CC genotype. A significantly decreased risk for RA associated with the VEGFA rs699947 CA genotype was evident among older patients. Conclusions: These findings suggest that the functional single nucleotide polymorphism (SNP) VEGFA rs699947 C/A allele may decrease the risk of RA in older patients and ACPA-negative patients. However, our results were obtained from a moderate-sized sample and therefore this is a preliminary conclusion. Validation by a larger study from a more diverse ethnic population is needed to confirm these findings.
An in vitro comparative evaluation of physical properties of four different types of core materials

Introduction: Compressive and tensile stresses of core materials are important properties because cores usually replace a large bulk of tooth structure and must resist multidirectional masticatory forces for many years. Material and Methods: The present study was undertaken to find out the best core build up material with respect to their physical properties among resin-based composites. Individual compressive, tensile, and flexural strength of fiber-reinforced dual cure resin core build up material, silorane-based composite resin, and dual curing composite for core build up with silver amalgam core was used as control were evaluated and compared using universal testing machine. Data were statistical analysed using Kruskal-Wallis test to determine whether statistically significant differences (P < 0.05) existed among core materials. Both dual cure composite materials with nanofillers were found superior to amalgam core. The silorane-based material showed the highest flexural strength, but other mechanical properties were inferior to dual cure composite materials with nanofillers.
Shaking Up the Equilibrium: Natural Disasters, Economic Activity, and Immigration

This paper examines the long-run effects on the spatial distribution of economic activity caused by historical shocks. Using variation in the potential damage intensity of the 1906 San Francisco Earthquake across cities in the American West, we show that more severely affected cities experienced lower population growth relative to less affected cities after the earthquake. This negative effect persisted until the late 20th century. The earthquake diverted migrants to less affected areas in the region, which, together with reinforcing dynamic agglomeration effects from scale economies, left a long-lasting mark on the location of economic activity in the American West.
Methodological and Ethical Dilemmas of Archiving Qualitative Data

The Finnish Social Science Data archive started archiving qualitative data in 2003. Many researchers found this to be highly problematic. Their main reason for opposing the archiving of qualitative data was research ethics. Researchers who oppose the archiving of qualitative interviews mainly appeal to the confidential nature of the interview situation. This kind of argument against archiving is put under scrutiny in this article. It covers issues such as the presentation of research subjects and the understanding of research relationship. Researchers tend to define the interview relationship as unpredictable and private, and interviewees as helpless participants in need of protection. In contrast, the interviewees themselves define the relationship as an institutional one aiming to foster science.
Fast-Disintegrating Sublingual Epinephrine Tablets: Effect of Tablet Dimensions on Tablet Characteristics

ABSTRACT The purpose of this study was to evaluate the effect of changing dimensions on the hardness (H), disintegration time (DT), and wetting time (WT) of fast-disintegrating epinephrine tablets for sublingual administration as potential first aid treatment for anaphylaxis. Tablet formulations I and II, containing 0% and 10% epinephrine bitartrate, respectively, and weighing 150 mg were prepared by direct compression. Formulations were compressed at a range of forces using an 8/32″ die with concave punches (CP); a 10/32″ and an 11/32″ die with CP and flat punches (FP). Tablet weight variation, content uniformity, thickness, H, DT, and WT were measured. The 8/32″, 10/32″, and 11/32″ dies resulted in tablet thickness of ranges 0.25–0.19″, 0.17–0.1″, and 0.16–0.08″, respectively. The DT and WT using the 8/32″ die were ≤10 and ≤30 sec, respectively, at H ≤5.4 ± 0.2 kg for formulation I, and H ≤5.4 ± 0.3 kg for formulation II. The DT and WT were ≤10 and ≤30 sec, respectively, using 10/32″ die/CP, 10/32″ die/FP, 11/32″ die/CP, and 11/32″ die/FP at H ≤6.2 ± 0.6 kg, ≤6.8 ± 0.4 kg, ≤4.9 ± 0.1 kg, and ≤7.2 ± 0.3 kg, respectively, for formulation I. For formulation II, the DT and WT were ≤10 sec and ≤30 sec, respectively, when H < 4 kg. No difference in DT and WT was observed between concave and flat tablets. The 11/32″ and 10/32″ dies resulted in more ideal tablet dimensions for sublingual administration, but H must be maintained <4 kg to ensure rapid DT and WT.
Postoperative Disability After Long Corrective Fusion to the Pelvis in Elderly Patients With Spinal Deformity

Study Design. A prospective case series analysis. Objective. The purpose of this study was to investigate the degree of difficulty in daily activities of adult spinal deformity (ASD) patients after corrective long fusion to the pelvis, with an emphasis on bend forward activities. Summary of Background Data. No prospective studies have been reported regarding the postoperative impairments and their time course after long fusion in ASD patients. Methods. One-hundred three patients [26 men, 77 women; mean age 68 (50–82) years] who underwent corrective long fusion from the thoracic spine to the pelvis were included. As a control group, 578 volunteers [213 men, 365 women; mean age 72 (50–84)] who underwent musculoskeletal examination were included. Seven daily activities were assessed using Disability Scores (DS10), which ask patients to rate the difficulty of actions from 1 (very easy) to 10 (very difficult). The activities selected were a) gait, b) ability to trim toe nails, c) lie supine, d) perform personal hygiene, e) put on pants, f) pick up an item from the floor, and g) get down on all fours. Each of these activities were rated by all volunteers and patients at five assessment points in 2 years. Questionnaires (ODI, SRS-22, and DS10) were administered preoperatively, at discharge, 6 months, 1 year, and 2 years postoperatively. Radiographic parameters and clinical results of the control group were compared with those of the ASD patients and the patients with different upper instrumented vertebrae. Results. Although successful clinical results and deformity corrections were achieved, the ASD patients reported significant difficulty in b), d), e), f), and g) after the surgery (all P < 0.0001), regardless of the fusion length. The difficulty gradually improved toward 2 years but did not reach preoperative status. Conclusion. Activities requiring patients to bend forward were more difficult for elderly ASD patients postoperatively. Level of Evidence: 3
Effect of labor epidural anesthesia on breast-feeding of healthy full-term newborns delivered vaginally.

BACKGROUND Epidural anesthesia is commonly administered to laboring women. Some studies have suggested that epidural anesthesia might inhibit breast-feeding. This study explores the association between labor epidural anesthesia and early breast-feeding success. METHODS Standardized records of mother-baby dyads representing 115 consecutive healthy, full-term, breast-feeding newborns delivered vaginally of mothers receiving epidural anesthesia were analyzed and compared with 116 newborns not exposed to maternal epidural anesthesia. Primary outcome was two successful breast-feeding encounters by 24 hours of age, as defined by a LATCH breast-feeding assessment score of 7 or more of 10 and a latch score of 2/2. Means were compared with the Kruskal-Wallis test. Categorical data were compared using the Mantel-Haenszel chi-square test. Stratified analysis of potentially confounding variables was performed using Mantel-Haenszel weighted odd ratios (OR) and chi-square for evaluation of interaction. RESULTS Both epidural and nonepidural anesthesia groups were similar except maternal nulliparity was more common in the epidural anesthesia group. Two successful breast-feedings within 24 hours of age were achieved by 69.6% of mother-baby units that had had epidural anesthesia compared with 81.0% of mother-baby units that had not (odds ratio [OR] 0.53, P = .04). These relations remained after stratification (weighted odds ratios in parenthesis) based on maternal age (0.52), parity (0.58), narcotics use in labor (0.49), and first breast-feeding within 1 hour (0.49). Babies of mothers who had had epidural anesthesia were significantly more likely to receive a bottle supplement while hospitalized (OR 2.63; P < .001) despite mothers exposed to epidural anesthesia showing a trend toward being more likely to attempt breast-feeding in the 1 hour (OR 1.66; P = .06). Mothers who had epidural anesthesia and who did not breast-feed within 1 hour were at high risk for having their babies receive bottle supplementation (OR 6.27). CONCLUSIONS Labor epidural anesthesia had a negative impact on breast-feeding in the first 24 hours of life even though it did not inhibit the percentage of breast-feeding attempts in the first hour. Further studies are needed to elucidate the exact nature of this association.
Parkinson's disease: The quintessential neuropsychiatric disorder

Although diagnosed by characteristic motor features, Parkinson's disease may be preceded, and is frequently accompanied by, a wide range of cognitive and neuropsychiatric features. In addition to the most commonly studied disorders of dementia, depression, and psychosis, other relatively common and clinically significant psychiatric complications include impulse control disorders, anxiety symptoms, disorders of sleep and wakefulness, and apathy. These problems may be underrecognized and are frequently undertreated. The emergent focus on nonmotor aspects of Parkinson's disease over the past quarter of a century is highlighted by a nonlinear increase in the number of articles published devoted to this topic. Although the development of newer antidepressants, atypical antipsychotics, and cholinesterase inhibitors in recent years has had a positive benefit on the management of these troublesome and distressing symptoms, responses are frequently suboptimal, and this remains an area of major unmet therapeutic need. © 2011 Movement Disorder Society
Time lags in watershed-scale nutrient transport: an exploration of dominant controls

Unprecedented decreases in atmospheric nitrogen (N) deposition together with increases in agricultural N-use efficiency have led to decreases in net anthropogenic N inputs in many eastern US and Canadian watersheds as well as in Europe. Despite such decreases, N concentrations in streams and rivers continue to increase, and problems of coastal eutrophication remain acute. Such a mismatch between N inputs and outputs can arise due to legacy N accumulation and subsequent lag times between implementation of conservation measures and improvements in water quality. In the present study, we quantified such lag times by pairing long-term N input trajectories with stream nitrate concentration data for 16 nested subwatersheds in a 6800 km2, Southern Ontario watershed. Our results show significant nonlinearity between N inputs and outputs, with a strong hysteresis effect indicative of decadal-scale lag times. The mean annual lag time was found to be 24.5 years, with lags varying seasonally, likely due to differences in N-delivery pathways. Lag times were found to be negatively correlated with both tile drainage and watershed slope, with tile drainage being a dominant control in fall and watershed slope being significant during the spring snowmelt period. Quantification of such lags will be crucial to policy-makers as they struggle to set appropriate goals for water quality improvement in human-impacted watersheds.
A comprehensive classification of monetary policy frameworks in advanced and emerging economies

The paper presents a new classification of monetary policy frameworks that it applies to advanced and emerging economies for the period since the end of the Bretton Woods international monetary system, with a focus on the monetary authorities’ objectives (domestic and external), and on pre-announced targets and actual performance. The classification (available at www.monetaryframeworks.org) also emphasizes the underlying monetary and financial infrastructure that conditions the instruments available to the authorities and, therefore, the coherence of different frameworks. It is constructed mainly from a close reading of IMF Article IV consultation reports. The two major changes revealed by the data are the trends over time towards a heavier focus on inflation, and towards more systematic and coherent monetary arrangements.
Strategies to address global cesarean section rates: a review of the evidence.

BACKGROUND The steadily increasing global rates of cesarean section has become one of the most debated topics in maternity care. This paper reviews and reports on the success of strategies that have been developed in response to this continuing challenge. METHODS A literature search identified studies conducted between 1985 and 2001 from the Cochrane Database of Systematic Reviews, Medline, Sociofile, Current Contents, Psyclit, Cinahl, and EconLit databases. An additional search of electronic databases for Level 1 evidence (systematic reviews), Level 2 (randomized controlled trials), Level 3 (quasi-experimental studies), or Level 4 (observational studies) was performed. Selection criteria used to identify studies for review included types of study participant, intervention, outcome measure, and study. RESULTS Interventions that have been used in an attempt to reduce cesarean section rates were identified; they are categorized as psychosocial, clinical, and structural strategies. Two clinical interventions, (external cephalic version, vaginal birth after a previous cesarean) and one psychosocial intervention (one-to-one trained support during labor) demonstrated Level 1 evidence for reducing cesarean section rates. CONCLUSIONS Although the evidence for one-to-one care and external cephalic version came from both developed and developing settings, the systematic review for vaginal birth after a cesarean was restricted to studies conducted in the United States. The effective implementation of the preceding strategies to reduce cesarean rates may depend on the social and cultural milieu and on associated beliefs and practices.
A critical comparison of echocardiographic measurements used for optimizing cardiac resynchronization therapy: stroke distance is best

Dyssynchrony assessment in cardiac resynchronization therapy (CRT) is controversial, and there are no standard protocols for optimizing treatment. We studied the feasibility and reproducibility of several echocardiographic measures to optimize CRT pacemaker settings. We also assessed the utility of ‘stroke distance’ [left ventricular outflow tract velocity–time integral (LVOT VTI)] in performing this function.
Retinopathy of prematurity: frequency and risk factors in a tertiary care hospital in Karachi, Pakistan.

INTRODUCTION To determine the frequency of Retinopathy of Prematurity (ROP) in the premature infants born in a tertiary care hospital and to determine the risk factors associated with it. METHODS This was a retrospective analysis of premature infants with birth weight < or = 1500 grams or gestational ago < or = 32 weeks, admitted to the Neonatal Intensive Care Unit of a tertiary care hospital in a three year period. The infants underwent eye examinations between their 4th and 7th week of life. Univariate and multiple logistic regression analysis were performed to determine the association between risk factors and ROP development. RESULTS Sixty eight infants were included in the analysis. Out of these, 22 (32.4%) developed ROP (inclusive of all stages) and 14 (20.6%) developed threshold disease. Multiple logistic regression analysis revealed that low gestational age, sepsis and respiratory distress syndrome were independent predictors for the development of ROP. CONCLUSION The frequency of ROP in our hospital was on the higher side of the range reported in neighbouring developing countries. Low gestational age, sepsis and respiratory distress syndrome were independent predictors of ROP development. Our results suggest that ROP is an important emerging cause of preventable childhood blindness in urban areas of Pakistan like Karachi.
B and T Lymphocyte Attenuator Is Highly Expressed on CMV-Specific T Cells during Infection and Regulates Their Function

B and T lymphocyte attenuator (BTLA), like its relative programmed cell death-1 (PD-1), is a receptor that negatively regulates murine T cell activation. However, its expression and function on human T cells is currently unknown. We report in this study on the expression of BTLA in human T cell subsets as well as its regulation on virus-specific T cells during primary human CMV infection. BTLA is expressed on human CD4+ T cells during different stages of differentiation, whereas on CD8+ T cells, it is found on naive T cells and is progressively downregulated in memory and differentiated effector-type cells. During primary CMV infection, BTLA was highly induced on CMV-specific CD8+ T cells immediately following their differentiation from naive cells. After control of CMV infection, BTLA expression went down on memory CD8+ cells. Engagement of BTLA by mAbs blocked CD3/CD28-mediated T cell proliferation and Th1 and Th2 cytokine secretion. Finally, in vitro blockade of the BTLA pathway augmented, as efficient as anti–PD-1 mAbs, allogeneic as well as CMV-specific CD8+ T cell proliferation. Thus, our results suggest that, like PD-1, BTLA provides a potential target for enhancing the functional capacity of CTLs in viral infections.
Optical Damage Limits to Pulse Energy From Fibers

The irradiances or fluences encountered in pulsed fiber lasers and amplifiers are sometimes high enough to destroy the fiber. The ultimate limit is set by the intrinsic damage threshold irradiance of doped silica. Other nonlinear processes such as self-focusing and stimulated Brillouin scattering are also important. We present here the results of our measurements of the damage threshold, and of our analysis of how self-focusing and Brillouin scattering influence the power limit.
Gendered approach to managing change in organisations : differences in the way men and women manage organisational change in Abuja, Nigeria

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