Miracle-dz/UniFAR-FTUs huggingface dataset:
Being asked not to tell: nurses' experiences of caring for cancer patients not told their diagnosis.

AIMS AND OBJECTIVES The aim of the primary research was to investigate the impact of the nurse-patient relationship on clinical learning and subsequently clinical practice. Coincidently, 32 participants, all Registered Nurses in Hong Kong, provided details of nurse-patient encounters involving withholding of a cancer diagnosis. BACKGROUND The changing face of clinical practice and cancer care has fuelled discussion and debate around disclosure or non-disclosure of the diagnosis of cancer, global consensus on this issue still does not exist. In different countries there is marked variation in how and what a patient may be told about their diagnosis and prognosis. There is considerable variability in the reported rate of cancer diagnosis disclosure across studies and countries. Being asked not to tell a patient their diagnosis of cancer presents many problems for nurses caring for those patients. The issue of non-disclosure directly affects nurses and their clinical practice. METHODS This paper reports one of the findings of a large international qualitative study informed by phenomenology into the perceptions of nurses about caring for a patient with a diagnosis of cancer. RESULTS Responses from participants revealed considerable difficulties for nurses when caring for patients who were not informed of their diagnosis. They recounted having learned from the encounters but remarked on the negativity of the experience. They discussed their inability to act decisively in the past situations but expressed hope that they had found a resolve to act in future. RELEVANCE TO CLINICAL PRACTICE Although, overwhelmingly, participants doubted they would actually be able to change the reality of practice. The identified care episode and the nurse-patient relationship, according to participants, did change their clinical practice but often not for the better.
Risk factors for fracture in a UK population: a prospective cohort study.

BACKGROUND Common clinical risk factors for fracture in older women have been identified. To date, most of these risk factors have not been confirmed in a UK population. AIM To confirm the important risk factors for fracture in older women. DESIGN Comprehensive cohort study (CCS) with a nested randomized controlled trial. METHODS The CCS included 4292 women aged >70 years. We assessed potential risk factors for fracture, and followed-up participants for 24 months for incidence of non-vertebral fractures. RESULTS Odds ratios (ORs) for predicting any non-vertebral fracture were: previous fracture, 2.67 (95%CI 2.10-3.40); a fall in the last 12 months, 2.06 (95%CI 1.63-2.59); and age (per year increase), 1.03 (95%CI 1.01-1.05). ORs for predicting hip fracture were: previous fracture, 2.31 (95%CI 1.31-4.08); low body weight (<58 kg), 2.20 (95%CI 1.28-3.77); maternal history of hip fracture, 1.68 (95%CI 0.85-3.31); a fall in the last 12 months, 2.92 (95%CI 1.70-5.01); and age (per year increase), 1.09 (95%CI 1.04-1.13). ORs for predicting wrist fracture were: previous fracture, 2.29 (95%CI 1.56-3.34); and a fall in the last 12 months, 1.60 (95%CI 1.10-2.31). Being a current smoker was not associated with an increase in risk, and was consistent across all fracture types. DISCUSSION Older women with the clinical risk factors identified in this study should be investigated for osteoporosis or offered preventive treatment.
Mycophenolate Mofetil: How to Further Improve Using an Already Successful Drug?

In an organ-by-organ review on trends in immunosuppressive therapy, Kaufman et al. recently showed that at discharge from the hospital mycophenolate mofetil (MMF) was used by 79% of kidney transplant recipients (1). For MMF the official recommendation is to use 2 g daily. This recommendation is based on the results of three phase III, randomized, double-blind, multicenter trials, that showed that compared to 2 g of MMF daily with 3 g there was no further reduction in the incidence of acute rejection after kidney transplantation (2). These three studies were all cyclosporine-based. Since then a variety of other drug combinations has been used, such as tacrolimus/MMF, sirolimus/MMF and MMF/steroids. For these combinations another daily dose may be necessary, and the 2-g daily dose is under discussion. Other reasons to consider individualization of dose rather than using standard dose therapy are the large inter-individual variability in pharmacokinetics (PK) and pharmacodynamics (PD) of this drug.
Combined Minimally Invasive Redo Mitral Surgery and Pectus Excavatum Correction

We present a technique of mitral valve surgery performed in a patient with severe pectus excavatum and previous Bentall surgery. Neither redo sternotomy nor conventional right minithoracotomy were thought to provide adequate surgical access to the mitral valve. We therefore opted for a combined procedure comprising sternal reconstruction and right minithoracotomy mitral valve replacement. The mitral valve was replaced and the sternum reconstructed according to the Ravitch technique. doi: 10.1111/jocs.12559 (J Card Surg 2015;30:570–573)
Prognostic factors for survival in breast cancer patients who developed distant metastasis subsequent to definitive surgery.

INTRODUCTION The present study was undertaken to define the prognostic factors for overall survival subsequent to definitive surgery, and for survival after the development of distant metastasis in breast cancer patients who developed distant metastasis subsequent to definitive surgery. METHODS The records of 470 breast cancer patients with T1-3 tumours and distant metastasis following surgery were reviewed. Prognostic factors were compared to the first metastatic sites as solitary skeletal, multiple skeletal, and visceral metastases, and were analysed for overall survival following surgery and survival after metastasis. Survival curves were generated by the Kaplan-Meier method, and multivariate analysis was performed by the Cox proportional hazard model. RESULTS 79 patients (17 percent) had a solitary skeletal metastasis, 105 (22 percent) had multiple skeletal metastases, and 286 (61 percent) had a visceral metastasis. The five-year overall survival was significantly better for patients with a solitary bone metastasis (73 percent) compared to patients who had multiple bone metastases (46 percent), or a visceral metastasis (22 percent) (p-value is less than 0.0001). Pathological lymph node status 3, stage IIIC, grade 3, oestrogen receptor negativity, and visceral metastases were found to have independent detrimental influence on overall survival following surgery and survival after metastasis. A long-term metastasis-free interval affected post-metastatic outcome favourably. Radiotherapy improved overall survival. CONCLUSION Pathological lymph node status, stage, grade, and oestrogen receptor status predicted survival after surgery as well as after the development of metastasis. Solitary bone metastasis has a more favourable prognosis than multiple bone metastases, and compared to visceral metastasis, skeletal metastasis has a more favourable prognosis.
Vagal nerve stimulation decreases blood-brain barrier disruption after traumatic brain injury

BACKGROUND Traumatic brain injury (TBI) may alter sympathetic tone causing autonomic abnormalities and organ dysfunction. Vagal nerve stimulation (VNS) has been shown to decrease inflammation and distant organ injury after TBI. It is unknown whether VNS may reduce blood-brain barrier (BBB) dysfunction after TBI. We hypothesize that VNS prevents TBI-induced breakdown of the BBB, subsequent brain edema, and neuronal injury. METHODS A weight-drop model was used to create severe TBI in balb/c mice. Animals were divided into three groups: TBI—TBI only; TBI or VNS—animals that were treated with 10 minutes of VNS immediately before TBI; and sham—animals with opening of the skull but no TBI and VNS treatment. Brain vascular permeability to injected (Mr 70,000) FITC-dextran was measured by radiated fluorescence 6 hours after injury. Injured tissue sections were stained for perivascular aquaporin 4 (AQP-4), an important protein causing BBB-mediated brain edema. Fluorescence was quantified under laser scanning by confocal microscopy. RESULTS Six hours after TBI, cerebral vascular permeability was increased fourfold compared with sham (mean [SD], 6.6E+08 [5.5E+07] arbitrary fluorescence units [afu] vs. 1.5E+08 [2.9E+07] afu; p < 0.001). VNS prevented the increase in permeability when compared with TBI alone (mean [SD], 3.5 E+08 [8.3E+07] afu vs. 6.6E+08 [5.5E+07] afu; p < 0.05). Perivascular expression of AQP-4 was increased twofold in TBI animals compared with sham (mean [SD], 0.96 [0.12] afu vs. 1.79 [0.37] afu; p < 0.05). Similarly, VNS decreased post-TBI expression of AQP-4 to levels similar to sham (mean [SD], 1.15 [0.12] afu; p < 0.05). CONCLUSION VNS attenuates cerebral vascular permeability and decreases the up-regulation of AQP-4 after TBI. Future studies are needed to assess the mechanisms by which VNS maintains the BBB.
Treatment of ligature-induced peri-implantitis by lethal photosensitization and guided bone regeneration: a preliminary histologic study in dogs.

BACKGROUND The purpose of this pilot study was to evaluate the healing potential and reosseointegration in ligature-induced peri-implantitis defects adjacent to various dental implant surfaces following lethal photosensitization. METHODS A total of 36 dental implants with 4 different surface coatings (9 commercially pure titanium surface [CPTi]; 9 titanium plasma-sprayed [TPS]; 9 hydroxyapatite [HA]; and 9 acid-etched [AE]) were inserted in 6 male mongrel dogs 3 months after extraction of mandibular premolars. After a 2-month period of ligature-induced peri-implantitis and 12 months of natural peri-implantitis progression, only 19 dental implants remained. The dogs underwent surgical debridement of the remaining dental implant sites and lethal photosensitization by combination of toluidine blue O (100 microg/ml) and irradiation with diode laser. All exposed dental implant surfaces and bone craters were meticulously cleaned by mechanical means, submitted to photodynamic therapy, and guided bone regeneration (GBR) using expanded polytetrafluoroethylene (ePTFE) membranes. Five months later, biopsies of the implant sites were dissected and prepared for ground sectioning and analysis. RESULTS The percentage of bone fill was HA: 48.28 +/- 15.00; TPS: 39.54 +/- 12.34; AE: 26.88 +/- 22.16; and CPTi: 26.70 +/- 16.50. The percentage of reosseointegration was TPS: 25.25 +/- 11.96; CPTi: 24.91 +/- 17.78; AE: 17.30 +/- 15.41; and HA: 15.83 +/- 9.64. CONCLUSION These data suggest that lethal photosensitization may have potential in the treatment of peri-implantitis.
Tracking hands in action for gesture-based computer input

The ubiquity of modern computers in the form of smartphones, smartwatches, and virtual and augmented reality glasses has lead to the need to create new ways of computer input. Conventional input devices like the keyboard and the mouse can no longer be used for such emerging devices. The human hands are highly dexterous and could provide an alwayson input capability through the use of gestures. In this thesis, we introduce new methods for markerless tracking of the full articulated motion of hands and using tracked motion for gesture-based computer input. First, we contribute to computer vision-based markerless tracking of hands for use in computer input. This is a hard problem due to occlusions, uniform skin color, fast motions, and scene clutter. We show that combining novel representations for model-based tracking with discriminative learning techniques can result in mutually exclusive failure modes that help overcome some of the challenges. We show the benefit of our contributions in a variety of scenarios including varying number of cameras, viewpoints, and run-time requirements. We also show that our contributions can scale with scene complexity—it can be used, to our knowledge for the first time, to jointly track hands interacting with objects. Second, we contribute to gesture-based input driven by markerless hand tracking. The design of appropriate interaction techniques and gestures is a hard problem because of the large design space, and human factors such as ergonomics. We show that gestures elicited from users can be used to develop interaction techniques for 3D navigation tasks. We then identify limitations with elicitation studies and propose a novel method for computational gesture design. This allows designers, for the first time, to automatically generate gestures satisfying criteria such as speed or accuracy. Finally, we show that even limiting hand tracking to only fingertips can enable new input methods for small form factor devices such as smartphones. We conclude the thesis with a critical discussion about limitations and directions for future work.
Construction of the RSRP map using sparse MDT measurements by regression clustering

Radio environment maps are geographical maps with overlaid performance information of radio communication systems, that can be considered as one of the key enablers for self-organizing networks. After the introduction of Minimization of Drive Tests (MDT) to the standards, operators are interested to generate radio environment maps based on sparse sets of MDT measurements gathered from user equipment. In this paper, we consider the construction of the Reference Signal Received Power (RSRP) map, which is an example of a radio environment map using such a sparse MDT measurement set from user equipment. In particular, we propose a two-step algorithm for RSRP map generation which is shown to bring substantial performance improvement in terms of the mean absolute error of the predicted RSRP map as compared to the existing baseline methods, i.e., environmental-based regression and inverse distance weighting interpolation.
Caring as worrying: the experience of spousal carers.

BACKGROUND With the emerging focus on home-based care, there is an increasing demand on spouses to look after their chronically ill partners at home. The theoretical aspects of caring have been much discussed in the literature, but the pragmatic aspects have received less attention. Carer stress has been explored, but little has been written about the meaning of caring to informal carers. AIM The aim of this paper is to report one of the major themes that emerged from a study conducted between 1998 and 1999 to explicate the meaning of caring from the perspective of spousal carers for people with multiple sclerosis in order to shed light on and understand the challenges and demands these carers encountered. METHODOLOGY An interpretive phenomenological approach was used to describe spousal carers' experiences of caring for their partner. Ten spousal carers of people with multiple sclerosis participated. Data were collected through unstructured in-depth interviews and analysed by the method of hermeneutic analysis. FINDINGS This paper presents one of the major themes identified: 'caring as worrying'. While the meaning of caring that emerged from this theme supports many of the philosophical understandings of caring as discussed in the literature, worrying as a care responsibility provides a further insight. Caring as worrying describes caring as a complex emotional relationship of responsibility in these participants. They worried about their partners, their relationships with their partners and their future. They also worried about their own health, institutional care, and lack of government support. CONCLUSION Spousal carers' worries have significant implications for health care professionals. The findings provide insight into the concerns and worries the carers of people with multiple sclerosis face when caring for their chronically ill partners at home.
Danebury: An Iron Age Hillfort in Hampshire. Vol. 4. The Excavations, 1979-1988: The Site@@@Danebury: An Iron Age Hillfort in Hampshire. Vol. 5. The Excavations, 1979-1988: The Finds@@@Maiden Castle@@@Maiden Castle. Excavations and Field Survey 1985-6

Danebury: An Iron Age Hillfort in Hampshire. Vol. 4. The Excavations, 1979-1988: The Site. Vol. 5. The Excavations 1979-1988: The Finds. By B. Cunliffe and C. Poole. CBA Research Report 73. Council for British Archaeology, London, 1991. Pp. ix + 276; vi + 217, numerous ills. Price: £101.00 (2 vols). ISBN 1 872414 02 8; 1 872414 20 6. Maiden Castle. By N.M. Sharpies. Batsford and English Heritage, London, 1991. Pp. 143, pis 27, figs 43, maps 6, plans 15. Price: £12.95 (paper), ISBN 0 7134 6083 o (paper). Maiden Castle. Excavations and Field Survey 1985-6. By N.M. Sharpies. English Heritage Archaeological Report 19. Historic Buildings and Monuments Commission for England, London, 1991. Pp. xii + 284, numerous ills, fiches 10 (with photocopy index) not supplied with volume but available free on application. Price: £35.00. ISBN 1 85074 273 1.
Nondivergence of horocyclic flows on moduli space

The earthquake flow and the Teichmüller horocycle flow are flows on bundles over the Riemann moduli space of a surface, and are similar in many respects to unipotent flows on homogeneous spaces of Lie groups. In analogy with results of Margulis, Dani and others in the homogeneous space setting, we prove strong nondivergence results for these flows. This extends previous work of Veech. As corollaries we obtain that every closed invariant set for the earthquake (resp. Teichmüller horocycle) flow contains a minimal set, and that almost every quadratic differential on a Teichmüller horocycle orbit has a uniquely ergodic vertical foliation. Stony Brook IMS Preprint #2000/8 September 2000
Molecular and clinical role of phytoestrogens as anti-skin-ageing agents: A critical overview

Accumulated evidence from epidemiological, clinical, and laboratory studies have supported the important role of estrogens on skin physiology. Estrogen therapy has been demonstrated as a therapy for the signs of ageing related to estrogen deficiency in menopausal women. Unlike cosmetic products, estrogens cannot be used as therapy for skin-ageing in all women due to their potencies and ability to produce undesirable side-effects. Therefore, the use of phytoestrogens as natural product remedies to alleviate skin-ageing is more common. Current literature suggests that phytoestrogens offer improvement and delay signs of skin-ageing similar to the effects of estrogens. Moreover, the lack of side-effects when using phytoestrogens points towards their safety. This review article summarizes the evidence for the potential use of phytoestrogens as an alternative method for the alleviation or prevention of the signs of skin-ageing related to estrogen loss after menopause. The classification, mechanism of action, and pharmacology by which phytoestrogens can cause changes in skin-ageing are also discussed. Additionally, gaps in information about phytoestrogens and the most promising future research are mentioned.
Manpower strategies for flexible organisations

‘There is no overwhelming evidence of a significant expansion in this type of employment in the 1980s. The only employment forms for which the evidence of expansion is unambiguous are self-employment and part-time employment. The latter is in any case primarily both permanent and direct employment. Temporary and contract work, homeworking and black economy work are the employment forms where expansion appears to have been at best modest. ’ (Rubery,1988, pp. 56-57.)
Clinical and Imaging Findings in Cryptogenic Stroke Patients With and Without Patent Foramen Ovale: The PFO-ASA Study

Background and Purpose— Patent foramen ovale (PFO) has been identified as a potential risk factor for stroke, but the mechanisms of PFO-associated stroke remain unsettled. The aim of our study was to evaluate possible differences in stroke risk factors and stroke patterns between patients with and without PFO that may give clues to the mechanism of PFO-associated stroke. Methods— This prospective, multicentric study involved 581 young cryptogenic stroke patients. The presence of PFO and atrial septal aneurysm was assessed by transesophageal echocardiography and reviewed independently by 2 experienced sonographers. Clinical, brain, and vascular imaging findings were reviewed by 2 neurologists and 2 neuroradiologists. Results— Of the 581 stroke patients, 267 (45.9%) had PFO. Patients with PFO were younger (OR, 0.95; 95% CI, 0.93 to 0.97) and less likely to have traditional risk factors such as hypertension (OR, 0.49; 95% CI, 0.28 to 0.85), hypercholesterolemia (OR, 0.56; 95% CI, 0.34 to 0.93), or current smoking (OR, 0.67; 95% CI, 0.47 to 0.97). Features suggestive of paradoxical embolism, such as Valsalva-provoking activities or deep vein thrombosis, were not more frequent in patients with PFO. Migraine was more common in patients with PFO (27.3%) than in those without PFO (14.0%). PFO (OR, 1.75; 95% CI, 1.08 to 2.82), particularly when associated with atrial septal aneurysm (OR, 2.71; 95% CI, 1.36 to 5.41), was significantly associated with migraine after adjustment for age and sex. Conclusions— Differences in stroke risk factors and stroke patterns suggest that different stroke mechanisms occur in patients with and without PFO. PFO is significantly and independently associated with migraine, and this association is even stronger in patients with PFO and atrial septal aneurysm.
Family-centred service: differences in what parents of children with cerebral palsy rate important.

BACKGROUND A family-centred approach to services of children with disabilities is widely accepted as the foundational approach to service delivery in paediatric health care. The 56 items of the Measure of Processes of Care questionnaire (MPOC-56) all reflect elements of family-centred service. In this study, we investigated which elements of family-centred service are rated important by parents of children with cerebral palsy by adding a question on importance to each item of the MPOC-56 (MPOC-56-I). METHODS In total, 175 parents of children with cerebral palsy completed the MPOC-56-I. For each MPOC item, parents were asked to rate the importance on a 5-point scale ranging from 0 (not important at all) up to and including 4 (very important). We used Spearman's rank correlation coefficient to further explore the variation in parents' importance ratings. RESULTS Parents' importance ratings of the MPOC-56 items varied. The percentage of parents rating an item important (importance rating 3 or 4) varied between 43.8% and 96.8%. The percentage of parents rating an item unimportant (rating 0 or 1) varied between 0.0% and 20.3%, and the percentage of parents rating an item neutral (rating 2) varied between 3.0% and 36.0%. Most diverse importance ratings were found for five items concerning the provision of general information. Three correlations between these items and child and parent characteristics were found. Six items were rated important by almost all (≥95%) parents. These items concern elements of specific information about the child, co-ordinated and comprehensive care for child and family and enabling and partnership. CONCLUSIONS Parents rate the importance of family-centred services for their situation in various ways. These findings endorse that family-centred services should recognize the uniqueness of families and should be tailored to what parents find important.