Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Course of Node-Positive Squamous Cell Carcinoma of the Vulva without Adjuvant Radiotherapy

Aim: Radiotherapy, the most important adjuvant treatment modality for node-positive vulvar cancer, can cause severe lymphedema after inguinofemoral lymphadenectomy. To investigate the prognosis and toxicity outcomes of patients with node-positive vulvar cancer treated with surgery but not adjuvant radiotherapy. Methods: We performed a retrospective analysis of six patients who were treated at our center from 1992 to 2015. All of these patients underwent radical surgery accompanying inguinofemoral lymphadenectomy, and were histologically diagnosed with node-positive squamous cell carcinoma of the vulva. Results: The median length of survivor follow-up was 52 months, and the median number of lymph node metastases was 1.5 (range=1-4). Four patients received adjuvant platinum-based combined chemotherapy, and the other two patients refused chemotherapy. Recurrence was seen in three cases, and one patient who showed local recurrence had not received adjuvant chemotherapy. The median length of time to recurrence was 14 months. For the three patients with local recurrence, two patients showed local recurrence and one showed lung metastasis; radiotherapy was administered for these patients. The 3-year progression-free survival rate was 41.7%, and the 3-year overall survival rate was 80%. Grade 3 neutropenia was seen in one patient. Conclusion: We showed a favorable prognosis of node-positive squamous cell carcinoma of the vulva without adjuvant radiotherapy. Adjuvant chemotherapy without radiotherapy may avoid excessive local therapy, and is expected to decrease distant metastasis risk, resulting in favorable prognosis. Further clinical trials are needed to prove its utility.
Patient-Assisted Computerized Education for Recipients of Implantable Cardioverter Defibrillators: A Randomized Controlled Trial of the PACER Program

Background and Research Objective: Patients with implantable cardioverter defibrillators (ICDs) are at risk for postimplant anxiety. Computerized treatments for anxiety are well supported and desirable because of accessibility, anonymity, and cost-effectiveness. However, there currently exists no computerized psychosocial treatment for ICD populations. Our objective was to evaluate whether a pilot program (patient-assisted computerized education for recipients of ICDs [PACER of ICDs]) of a computerized intervention for ICD patients would improve ICD-related knowledge and psychological outcomes versus usual care. Outcomes were also compared with those from a related study that used the same intervention but in an in-person format. Subjects and Methods:Patients (N = 30) with an ICD were randomized to PACER or usual care. Mean time from implantation was 10.71 months (SD, 21.81 months). Outcomes included ICD-related knowledge, trait anxiety, defibrillation-related anxiety, patient acceptance of the ICD, and quality of life. Patients were assessed at baseline and at 1 month follow-up. Results and Conclusions:Knowledge score over time did not differ by treatment group, although both groups improved their scores. Among treatment patients, increased knowledge accounted for a significant amount of variance in device acceptance (R2 change = 0.30, P =.02), irrespective of age, education, ejection fraction, and time from implantation. There was no relationship between knowledge and device acceptance among control patients. Compared with previous recipients, new device recipients (< 3 months) were more likely to demonstrate an increase in knowledge (P =.01), greater defibrillation anxiety (P =.02), and worse patient acceptance (P =.04). Patient-assisted computerized education for recipients of ICDs resulted in comparable improvements in trait anxiety, quality of life, and device acceptance as the in-person treatment. The potential utility of PACER to enhance device acceptance lends support for further testing among larger samples.
Leptin and estradiol as related to change in pubertal status and body weight.

BACKGROUND Previous studies have examined the relationship between leptin, body mass, and pubertal status. The present study directly compares the relationship of leptin and estradiol in 5 groups of girls with different combinations of pubertal status and weight. MATERIAL/METHODS We studied girls with idiopathic precocious puberty, age-matched non-obese prepubertal girls, age-matched obese prepubertal girls, normal pubertal girls, and obese pubertal girls (n=12/group). RESULTS Leptin levels were significantly higher in obese pubertal girls (26.6+/-8.4 ng/mL) than in all others. Leptin levels were significantly higher in obese prepubertal girls (20.7+/-10.9 ng/mL) (mean+/-SD) compared to girls with precocious puberty (7.7+/-5.4 ng/mL, p<0.004), non-obese prepubertal girls (5.55+/-3.6 ng/mL, p<0.001), and normal pubertal girls (4.8+/-2.9 ng/mL, p<0.001). Leptin level did not correlate significantly with estradiol level. Leptin-SDS (standard deviation score), which corrects leptin level for gender, pubertal stage, and BMI, was significantly lower in the obese pubertal group than in the 3 non-obese groups. CONCLUSIONS These findings confirm previous studies that body mass, chronological age and pubertal stage are determinants of leptin level. However, these are not the only factors determining leptin level as evidenced by persistent differences in leptin level between obese and non-obese pubertal girls even when correcting for pubertal stage and BMI. While the present study provides no new answers to the question of pubertal regulation, it provides a direct comparison of combinations of weight, pubertal stage, and leptin level, as background for future studies.
Phase 2 Study of Ceftaroline versus Standard Therapy in Treatment of Complicated Skin and Skin Structure Infections

ABSTRACT Ceftaroline, the bioactive metabolite of ceftaroline fosamil (previously PPI-0903, TAK-599), is a broad-spectrum cephalosporin with potent in vitro activity against multidrug-resistant gram-positive aerobic pathogens, including methicillin-resistant Staphylococcus aureus. A randomized, observer-blinded study to evaluate the safety and efficacy of ceftaroline versus standard therapy in treating complicated skin and skin structure infections (cSSSI) was performed. Adults with cSSSI, including at least one systemic marker of inflammation, were randomized (2:1) to receive intravenous (i.v.) ceftaroline (600 mg every 12 h) or i.v. vancomycin (1 g every 12 h) with or without adjunctive i.v. aztreonam (1 g every 8 h) for 7 to 14 days. The primary outcome measure was the clinical cure rate at a test-of-cure (TOC) visit 8 to 14 days after treatment. Secondary outcomes included the microbiological success rate (eradication or presumed eradication) at TOC and the clinical relapse rate 21 to 28 days following treatment. Of 100 subjects enrolled, 88 were clinically evaluable; the clinical cure rate was 96.7% (59/61) for ceftaroline versus 88.9% (24/27) for standard therapy. Among the microbiologically evaluable subjects (i.e., clinically evaluable and having had at least one susceptible pathogen isolated at baseline), the microbiological success rate was 95.2% (40/42) for ceftaroline versus 85.7% (18/21) for standard therapy. Relapse occurred in one subject in each group (ceftaroline, 1.8%; standard therapy, 4.3%). Ceftaroline exhibited a very favorable safety and tolerability profile, consistent with that of marketed cephalosporins. Most adverse events from ceftaroline were mild and not related to treatment. Ceftaroline holds promise as a new therapy for treatment of cSSSI and other serious polymicrobial infections.
EPIC tile flow and nitrate loss predictions for three Minnesota cropping systems.

Subsurface tile drains are a key source of nitrate N (NO3-N) losses to streams in parts of the north central USA. In this study, the Erosion Productivity Impact Calculator (EPIC) model was evaluated by comparing measured vs. predicted tile flow, tile NO3-N loss, soil profile residual NO3-N, crop N uptake, and yield, using 4 yr of data collected at a site near Lamberton, MN, for three crop rotations: continuous corn (Zea mays L.) or CC, corn-soybean [Glycine max (L.) Merr. ] or CS, and continuous alfalfa (Medicago sativa L.) or CA. Initially, EPIC was run using standard Soil Conservation Service (SCS) runoff curve numbers (CN2) for CC and CS; monthly variations were accurately tracked for tile flow (r2 = 0.86 and 0.90) and NO3-N loss (r2 = 0.69 and 0.52). However, average annual CC and CS tile flows were underpredicted by -32 and -34%, and corresponding annual NO3-N losses were underpredicted by -11 and -52%. Predicted average annual tile flows and NO3-N losses generally improved following calibration of the CN2; tile flow underpredictions were -9 and - 12%, whereas NO3-N losses were 0.6 and -54%. Adjusting a N parameter further improved predicted CS NO3-N losses. Predicted monthly tile flows and NO3-N losses for the CA simulation compared poorly with observed values (r2 values of 0.27 and 0.19); the annual drainage volumes and N losses were of similar magnitude to those measured. Overall, EPIC replicated the relative impacts of the three cropping systems on N fate.
Trends in long-acting reversible contraceptive (LARC) use, LARC use predictors, and dual-method use among a national sample of college women

ABSTRACT Objective: Assess long-acting reversible contraceptive (LARC) and other contraceptive use trends, identify LARC use predictors, and examine dual method use. Participants: Women in the American College Health Association-National College Health Assessment (ACHA-NCHA) II, aged 18–24 years, who reported having vaginal sex (N = 37,899). Methods: Secondary analyses of Fall 2011–2014 ACHA-NCHA II data. Results: Statistically significant increases in LARC usage and, specifically, implant usage, were found. Characteristics associated with LARC use included age, race/ethnicity, relationship status, and school type. Students reporting LARC use had lower odds of condom usage compared with non-LARC hormonal method users. Conclusion: This analysis of LARC predictors and dual LARC/condom use has implications for research and health promotion efforts. Findings suggest that college health services are well positioned to meet the sexual and reproductive health needs of diverse populations of students. College health professionals should elicit students' individual and/or relationship priorities to tailor messaging/services offered for pregnancy/STI prevention.
High-speed photographs of a dielectric barrier atmospheric pressure plasma jet

The propagation of an atmospheric pressure plasma jet (APPJ) is investigated by use of an intensified charge coupled device (ICCD) camera. It is shown that the APPJ is mainly an electrical phenomenon and not a flow related one. The jet does not consist of a voluminous plasma. Much more, the presented plasma source acts like a "plasma gun" blowing small "plasma bullets" out of its mouth. Furthermore, the interaction of the jet with a surface has been investigated.
Nation Branding

India is a vast, diverse country, which attracts much attention as a political and economic entity as well as a major tourism destination. This commentary explores the Incredible India Campaign, a Nation Branding campaign which has been running in India for approximately ten years. In doing so, we consider nation branding as a mechanism for communicating between a nation and the rest of the world. We draw on a published account of the campaign by one of its architects, a series of images utilized in the campaign as well as a series of interviews with members of the pubic regarding their reaction to the images used. We argue that national branding campaigns can tell us much about imagined identities of those “being branded. ” In doing so, we illustrate the difficultly of representing a vast and diverse population within a fast developing economy as well as the benefits of placing the target of the campaign among “the other” rather than orientalizing the citizen at the heart of the nation branding campaign.
Hypertonic Fluid Administration in Patients With Septic Shock: A Prospective Randomized Controlled Pilot Study

ABSTRACT We assessed the short-term effects of hypertonic fluid versus isotonic fluid administration in patients with septic shock. This was a double-blind, prospective randomized controlled trial in a 15-bed intensive care unit. Twenty-four patients with septic shock were randomized to receive 250 mL 7.2% NaCl/6% hydroxyethyl starch (HT group) or 500 mL 6% hydroxyethyl starch (IT group). Hemodynamic measurements included mean arterial blood pressure (MAP), central venous pressure, stroke volume index, stroke volume variation, intrathoracic blood volume index, gastric tonometry, and sublingual microcirculatory flow as assessed by sidestream dark field imaging. Systolic tissue Doppler imaging velocities of the medial mitral annulus were measured using echocardiography to assess left ventricular contractility. Log transformation of the ratio MAP divided by the norepinephrine infusion rate (log MAP/NE) quantified the combined effect on both parameters. Compared with the IT group, hypertonic solution treatment resulted in an improvement in log MAP/NE (P = 0.008), as well as an increase in systolic tissue Doppler imaging velocities (P = 0.03) and stroke volume index (P = 0.017). No differences between the groups were found for preload parameters (central venous pressure, stroke volume variation, intrathoracic blood volume index) or for afterload parameters (systemic vascular resistance index, MAP). Hypertonic solution treatment decreased the need for ongoing fluid resuscitation (P = 0.046). No differences between groups were observed regarding tonometry or the sublingual microvascular variables. In patients with septic shock, hypertonic fluid administration did not promote gastrointestinal mucosal perfusion or sublingual microcirculatory blood flow in comparison to isotonic fluid. Independent of changes in preload or afterload, hypertonic fluid administration improved the cardiac contractility and vascular tone compared with isotonic fluid. The need for ongoing fluid resuscitation was also reduced.
Antiproliferative withanolides from several solanaceous species

To date, our work on solanaceous species (Datura wrightii, Jaborosa caulescens, Physalis hispida, Physalis longifolia, Vassobia breviflora and Withania somnifera) has resulted in the isolation of 65 withanolides, 31 of which were new, as well as the semi-synthesis of a further 30 withanolides. Structure identification and MTS assay-based antiproliferative evaluation of these 95 compounds revealed that a Δ2-1-oxo functionality in ring A, in conjunction with either a 5β,6β-epoxy or 5α-chloro-6β-hydroxy moiety in ring B, is the minimum structural requirement for withanolides to produce potent cytotoxic activity. Such structure–activity relationship analysis also revealed that oxygenation (the –OH or –OR groups) at C-4, 7, 11 and 12, as well as C-14 to C-28, did not contribute towards the observed antiproliferative activity. Herein, we present a complete overview of our work as it relates to the withanolides reported from 1965 to 2013.
School-aged homeless sheltered children's stressors and coping behaviors.

The purpose of this study was to examine the stressors and coping behaviors of school-aged homeless children staying in shelters. A secondary analysis of interview data from 30 children, between the ages of 8 to 12 years, was used to delineate the stressors and coping behaviors. Homeless, family, self, peer, school, and violent behavior were the stressor categories derived from content analysis. The children expressed more stresses in the homeless, family, and self categories than in the other 3 categories. The coping behaviors from the content analysis were categorized by using Ryan-Wenger's (1992) coping taxonomy. The majority of the children's coping responses were in the social support, cognitive avoidance, and behavioral distraction categories. Nurses should assess each child's stressors and coping behaviors when providing care to homeless children, and assist the child in alleviating some stressors by strengthening one's coping behaviors.
Robust adaptive voltage-fed permanent magnet step motor control without current measurements

In this paper, a robust adaptive nonlinear dynamic controller is designed to achieve practical stabilization for position tracking error of a voltage-fed permanent-magnet stepper motor. The control design is an output-feedback design that utilizes only rotor position and velocity measurements. Currents are not available for feedback. Adaptations are utilized so that no knowledge of motor parameters is required except for an upper and lower bound on the time constant of the electrical subsystem. Furthermore, these bounds are unnecessary under the assumption of sinusoidal flux distribution. The proposed controller has a dynamic order of three and is robust to load torques, cogging forces, and other disturbances satisfying certain bounds. The controller also guarantees asymptotic stabilization if the torque disturbances can be neglected and the asymptotic set-point regulation in the sinusoidal flux distribution case.
Immunolocalization of Tenascin-C in Vitiligo

The disappearance of melanocytes because of defective adhesion is one of the accepted theories to explain vitiligo. Tenascin-C is a large, extracellular matrix glycoprotein that is thought to inhibit adhesion of melanocytes to fibronectin. The current study aimed to evaluate the pattern of tenascin-C expression in vitiligenous skin compared with normal pigmented skin by means of immunohistochemistry. The study was carried out on skin biopsies from lesional and perilesional skin of 30 patients with vitiligo and on normal skin of 10 healthy volunteers. Several histopathologic changes were observed in vitiliginous skin such as keratinocyte vacuolization, a thickened basement membrane, and dermal inflammatory changes. Tenascin-C was expressed in keratinocytes of the basal epidermal layer of normal skin biopsies at a mild intensity but it did not stain the dermis, whereas vitiligenous skin showed tenascin-C expression in most cases (93.3% ), in the papillary dermis, epidermis, and in both. Diffuse epidermal expression of tenascin-C correlated with more loss of pigment and continuous staining of tenascin-C in the papillary dermis correlated with progressive forms of vitiligo. Intense tenascin-C expression was associated with a more progressive course of the disease assessed by the vitiligo disease activity score. From this study, tenascin-C is highly expressed in the dermis, epidermis, and both of vitiligo as a secondary event for the disease. Keratinocyte is a source of tenascin-C in vitiligo, and diffuse epidermal expression of tenascin-C may induce more loss of melanocytes and melanin pigment. Dermal expression of tenascin-C in the vitiligenous lesion may be linked to the disease more than epidermal expression, because this pattern is only seen in a vitiligenous lesion and it is completely absent in normal and perilesional skin.
Relationship between pterygomaxillary notches and maxillary anterior teeth.

PURPOSE Selection of the appropriate size of maxillary anterior teeth in complete dentures may be difficult, as there is no universally accepted method that can be used reliably. The aim of this study was to investigate whether there is a relationship between the total mesiodistal width of the six maxillary anterior teeth and the interpterygomaxillary notch distance. MATERIAL AND METHODS One hundred and ten maxillary impressions were made on dental students (67 women, 43 men; 19 to 22 years old) using stock tray and irreversible hydrocolloid impression material. The mesiodistal width of the six maxillary anterior teeth and the distance of the interpterygomaxillary notch were measured by digital caliper on stone casts (on two separate occasions by two independent observers). The results were analyzed using correlation regression tests. RESULTS The mean mesiodistal width of the six maxillary anterior teeth was 46.02 (+/-2.8) mm, and the mean distance of the interpterygomaxillary notch was 42.38 (+/-3.47) mm. A significant correlation was found between mesiodistal width of the maxillary anterior teeth and the interpterygomaxillary notch distance (p= 0.003; r = 0.28). Standardized coefficient was found to be low (28%) to predict the appropriate size of maxillary anterior teeth. CONCLUSION Total mesiodistal width of the maxillary anterior teeth correlated with the distance between pterygomaxillary notches; however, measurement of the interpterygomaxillary notch could not be used for tooth selection reliably due to the low standardized coefficient. Within the limitations of this study, the interpterygomaxillary notch distance is not useful for the selection of six maxillary anterior teeth in edentulous patients.
The mobile phone = bike shed? Children, sex and mobile phones

This article explores children’s use of mobile phones in relation to their intimate, sexual relationships and in their development of gendered sexual identities in their everyday lives. Implications of risk and mobile phones are reflected in current media discourse and contemporary public discussions. While the concept of risk remains at the centre of current sociological debate, children have only recently been seen as active social actors within social science. Based on the accounts of 30 young people aged between 11 and 17, the article adopts a social constructivist perspective to explore the relationship between young people’s talk of sexuality and sexual acts in their discussions of mobile phone use, within the wider theoretical debates about risk and self-identity.
[Microbial sensitivity of Escherichia coli in community-acquired urinary tract infections].

OBJECTIVE For effective empiric therapy of urinary tract infections in the extra-hospital setting the susceptibility pattern of uropathogens should be considered. Moreover, the evolution in sensitivity can be observed when comparing with susceptibility patterns in the previous years. This paper presents an analysis of our experience with Escherichia coli. MATERIAL AND METHODS During 2002 and 1998, 895 and 595 strains of Escherichia coli respectively, isolated from extrahospitalary bacteriurias were collected in ten health centers in Bierzo (León, Spain). Sensitivity to nine most commonly antibiotics used in the clinical practise was determined. The existence of significant differences of susceptibility among years (2002-1998) was analyzed by the chi square test. RESULTS Escherichia coli accounted for 63.4% of all isolates in 2002 and 50.8% in 1998. The prevalence of in-vitro susceptibilities to antibiotics were (2002-1998): fosfomycin (99.2%-99.3%; p = NS*), cefixime (98.3%-92.9%; p < 0.001), cefuroxime (96.5%-94.1%; p < 0.05), nitrofurantoin (94.5%-86.9%; p < 0.001), amoxycillin-clavulanic acid (93.1%-90.1%; p < 0.05), ciprofloxacin (77.1%-81.6%; p < 0.05), norfloxacin (75.8%-80.3%; p < 0.05), cotrimoxazole (71.5%-73.4%; p = NS*) and ampicillin (44%-41.4%; p = NS*). (*NS = No significant differences). CONCLUSION The knowledge of the sensitivity of uropathogens to antimicrobians in a specific medium can allow us to use antibiotics rationally and initiate empirical therapy.