Miracle-dz/UniFAR-FTUs huggingface dataset:
Colorectal endoscopic submucosal dissection: predictors and neoplasm-related gradients of difficulty

Abstract Background and study aim The role of colorectal endoscopic submucosal dissection (ESD) is standardized in Japan and East Asia, but technical difficulties hinder its diffusion. The aim was to identify predictors of difficulty for each neoplasm type. Methods A competent operator performed all procedures. ESD difficulty was defined as: en bloc with a slow speed (< 0.07 cm2/min; 30 × 30 mm neoplasm in > 90 min), conversion to endoscopic mucosal resection, or resection abandonment. Pre- and intraoperative difficulty variables were defined according to standard criteria, and evaluated separately for the rectum and colon. Difficulty predictors and gradients were evaluated by the multivariate logistic regression model. Results A total of 140 ESDs were included: 110 in the colon and 30 in the rectum. Neoplasms were laterally spreading tumors – granular type (LST-G) in 85 cases (61 %); the median longer axis was 30 mm (range 15 – 180 mm); a scar was present in 15 cases (11 %). ESD en bloc resection and difficulty rates were 85 % (n = 94) and 35 % (n = 39) in the colon, and 73 % (n = 22) and 50 % (n = 15) in the rectum (P = 0.17 and 0.28, respectively). The scar was the only preoperative predictor of difficulty in the rectum (odds ratio [OR] 12.3, 95 % confidence interval [CI] 1.27 – 118.36), whereas predictors in the colon were: scar (OR 12.7, 95 %CI 1.15 – 139.24), LST – nongranular type (NG) (OR 10.5, 95 %CI 1.20 – 55.14), and sessile polyp morphology (OR 3.1, 95 %CI 1.18 – 10.39). Size > 7 – ≤ 12 cm2 (OR 0.20, 95 %CI 0.06 – 0.74) and operator experience > 120 procedures (OR 0.19, 95 %CI 0.04 – 0.81) were predictors for a easy procedure. No intraoperative predictors of difficulty were identified in the rectum, whereas predictors in the colon were: severe submucosal fibrosis (OR 21.9, 95 %CI 2.11 – 225.64), ineffective submucosal exposure by gravity countertraction (OR 12.3, 95 %CI 2.43 – 62.08), and perpendicular submucosal dissection approach (OR 5.2, 95 %CI 1.07 – 25.03). When experience was /= 90, preoperative gradient of colonic ESD difficulty was the highest for LST-NGs (scar positive and negative up to 47 % and 20 %, respectively), intermediate for sessile polyps with scar (up to 23 %), and the lowest for LST-Gs (< 8 %). Different difficulty gradients between neoplasm types persisted with increasing experience: LST-NG rate up to 14 % after 120 procedures. Conclusions Colonic and rectal ESD difficulty has qualitative differences. Preoperative predictors should be considered to identify the difficulty gradient of each neoplasm type and the appropriate setting for ESD.
The Role of Multicultural Counselors to Help LGBT Against Discrimination Due to Failure of Communication

During their lives, LGBT (Lesbian, Gay, Bisexual, and Transgender) always get discrimination from the community because they are considered 'different'. The role of the counselor upholds the values of social justice, humanism, and universal goodness that can be accepted by LGBT people so that they can rise from discrimination and obtain appropriate health services. The purpose of this study is to formulate the multicultural competence of the counselor in serving LGBT clients. This article used the literature review method. The results based on the concept of multicultural counselor competence were developed to assist LGBT clients includes counselor's understanding of assumptions, biases, and cultural values; counselor awareness about the counselee's perspective; and appropriate cultural intervention strategies. Person centered therapy counseling techniques range from ways to receive statements and communication, respect for others and understand them. Some of the characteristics of counselors are as follows: acceptance, congruence, understanding, and nonjudgemental. It is concluded that values of humanism and respect for human rights are a manifestation of the character of multicultural counselors who are open to all kinds of differences, including differences in sexual orientation and gender identity. Guidance and counseling services for LGBT ideally guide and give counseling in the name of humanity.
The Personal Protective Behaviors of College Student Drinkers: Evidence of Indigenous Protective Norms

Abstract. Given the prevalence of alcohol consumption and the relative infrequency of harm among college students, the authors sought to determine how most college students protect themselves from alcohol-related harm. An analysis of the aggregate National College Health Assessment data identified a cluster of personal protective behaviors that correlated with reduced risk when drinking. Further analysis revealed that nearly three-quarters of student drinkers regularly employ at least 1 protective behavior, and well over half of the students who use protective behaviors routinely employ 2 or more. In addition, the data reveal that student drinkers employ situational abstinence, with nearly 7 out of 10 students reporting that they sometimes or usually refrain from drinking alcohol when they socialize. The use of these protective behaviors is a strong predictor of safety and harm for college-student drinkers.
Tandem constructs to mitigate transgene persistence: tobacco as a model

Some transgenic crops can introgress genes into other varieties of the crop, to related weeds or themselves remain as ‘volunteer’ weeds, potentially enhancing the invasiveness or weediness of the resulting offspring. The presently suggested mechanisms for transgene containment allow low frequency of gene release (leakage), requiring the mitigation of continued spread. Transgenic mitigation (TM), where a desired primary gene is tandemly coupled with mitigating genes that are positive or neutral to the crop but deleterious to hybrids and their progeny, was tested as a mechanism to mitigate transgene introgression. Dwarfism, which typically increases crop yield while decreasing the ability to compete, was used as a mitigator. A construct of a dominant ahasR (acetohydroxy acid synthase) gene conferring herbicide resistance in tandem with the semidominant mitigator dwarfing Δgai (gibberellic acid‐insensitive) gene was transformed into tobacco (Nicotiana tabacum). The integration and the phenotypic stability of the tandemly linked ahasR and Δgai genomic inserts in later generations were confirmed by polymerase chain reaction. The hemizygous semidwarf imazapyr‐resistant TM T1 (= BC1) transgenic plants were weak competitors when cocultivated with wild type segregants under greenhouse conditions and without using the herbicide. The competition was most intense at close spacings typical of weed offspring. Most dwarf plants interspersed with wild type died at 1‐cm, > 70% at 2.5‐cm and 45% at 5‐cm spacing, and the dwarf survivors formed no flowers. At 10‐cm spacing, where few TM plants died, only those TM plants growing at the periphery of the large cultivation containers formed flowers, after the wild type plants terminated growth. The highest reproductive TM fitness relative to the wild type was 17%. The results demonstrate the suppression of crop–weed hybrids when competing with wild type weeds, or such crops as volunteer weeds, in seasons when the selector (herbicide) is not used. The linked unfitness would be continuously manifested in future generations, keeping the transgene at a low frequency.
Attenuated insulin action on glucose uptake and transport in muscle following resistance exercise in rats.

A previous study reported elevations of insulin-mediated muscle protein synthesis following four days of resistance exercise in rats (Fluckey et al. 1996. Am J Physiol 270, E313-E319). The purpose of this study was to determine if insulin-stimulated muscle glucose uptake (a-v diff.) and 2-deoxyglucose (2-DG) transport were altered under similar conditions. The protocol consisted of squat-like exercises during four sessions with progressively increased weight (70-190 g). Each session consisted of 50 repetitions and sessions were separated by 48 h. Sixteen hours after the last exercise session, basal glucose uptake in perfused hindlimbs was not different (P > 0.05) between exercised (n=6) and non-exercised controls (n=6). However, there was a significant (P < 0.05) attenuation of insulin-stimulated (20 000 microU mL-1) glucose uptake in exercised vs. non-exercised rats (491 +/- 31 vs. 664 +/- 58 micromol glucose-1 g-1 [15-min insulin period]-1, respectively). Following resistance exercise, insulin-stimulated 2-DG transport, measured during the last 10 min of the perfusion period, was significantly reduced (P < 0.05) in the soleus, white gastrocnemius and extensor digitorum longus muscles. Additionally, GLUT-4 glucose transporter protein content was significantly reduced (P < 0.05) in white gastrocnemius and extensor digitorum longus muscles. These results demonstrate that insulin-stimulated glucose uptake and transport are reduced after resistance exercise. Furthermore, the applied resistance exercise protocol causes directionally opposite changes of insulin action in two major metabolic pathways, i.e. glucose transport and protein synthesis.
Uncoupling of neurovascular communication after transient global cerebral ischemia is caused by impaired parenchymal smooth muscle Kir channel function

Transient global cerebral ischemia is often followed by delayed disturbances of cerebral blood flow, contributing to neuronal injury. The pathophysiological processes underlying such disturbances are incompletely understood. Here, using an established model of transient global cerebral ischemia, we identify dramatically impaired neurovascular coupling following ischemia. This impairment results from the loss of functional inward rectifier potassium (KIR) channels in the smooth muscle of parenchymal arterioles. Therapeutic strategies aimed at protecting or restoring cerebrovascular KIR channel function may therefore improve outcomes following ischemia.
Response to preoperative chemotherapy in patients undergoing resection of pulmonary metastasis from soft tissue sarcoma – a predictor of outcome?

Abstract Approximately 50% of patients with high-grade soft tissue sarcoma (STS) will develop pulmonary metastasis. This is the most frequent cause of death and improving treatment is warranted. Preoperative chemotherapy is used for selected patients, usually those with less favorable prognosis and mainly outside clinical trials. The predicted value of histological and radiological response to preoperative chemotherapy on outcome was the main focus for this investigation. Patients and methods. This retrospective study comprises 93 patients with metachronous lung metastasis from STS who underwent complete metastasectomy alone (n = 41) or metastasectomy following preoperative chemotherapy (n = 52). Clinical data, histological and radiological responses to chemotherapy were recorded and survival analyses performed. Results. The time from initial STS diagnosis to the appearance of metastasis was shorter in the preoperative chemotherapy group than in those treated with surgery alone (p = 0.02). However, no statistical differences in post-metastasis disease-specific survival (DSS) or progression-free survival (PFS) between the groups were demonstrated. Patients in the preoperative chemotherapy group with good (complete) histological response had improved PFS compared with poor responders (p = 0.04). Radiological partial response was an independent, favorable prognostic factor for improved PFS and DSS (p = 0.003). Conclusion. Despite having unfavorable disease characteristics, some patients may benefit from preoperative chemotherapy. Both histological and radiological responses to preoperative chemotherapy seem to be prognostic in STS patients undergoing complete pulmonary metastasectomy.
Perturbation of Staphylococcus aureus Gene Expression by the Enoyl-Acyl Carrier Protein Reductase Inhibitor AFN-1252

ABSTRACT This study examines the alteration in Staphylococcus aureus gene expression following treatment with the type 2 fatty acid synthesis inhibitor AFN-1252. An Affymetrix array study showed that AFN-1252 rapidly increased the expression of fatty acid synthetic genes and repressed the expression of virulence genes controlled by the SaeRS 2-component regulator in exponentially growing cells. AFN-1252 did not alter virulence mRNA levels in a saeR deletion strain or in strain Newman expressing a constitutively active SaeS kinase. AFN-1252 caused a more pronounced increase in fabH mRNA levels in cells entering stationary phase, whereas the depression of virulence factor transcription was attenuated. The effect of AFN-1252 on gene expression in vivo was determined using a mouse subcutaneous granuloma infection model. AFN-1252 was therapeutically effective, and the exposure (area under the concentration-time curve from 0 to 48 h [AUC0–48]) of AFN-1252 in the pouch fluid was comparable to the plasma levels in orally dosed animals. The inhibition of fatty acid biosynthesis by AFN-1252 in the infected pouches was signified by the substantial and sustained increase in fabH mRNA levels in pouch-associated bacteria, whereas depression of virulence factor mRNA levels in the AFN-1252-treated pouch bacteria was not as evident as it was in exponentially growing cells in vitro. The trends in fabH and virulence factor gene expression in the animal were similar to those in slower-growing bacteria in vitro. These data indicate that the effects of AFN-1252 on virulence factor gene expression depend on the physiological state of the bacteria.
Separative pathways for urea and water, and for chloride in chicken erythrocytes.

1. Urea and water permeabilities of chicken erythrocytes are considerably lower than those of mammalian red cells. 2. The permeabilities to urea, thiourea and to N‐methylurea (about 10(‐6) cm/sec at 25 degrees C) were independent of concentration within a very broad range, and we found no evidence of interaction between transport of analogue molecules. The activation energies were between 17 and 19 kcal/mole, and urea transport was not inhibited by phloretin, which inhibits urea transport in mammalian red cells. 3. The water permeability of chicken red cells (as measured by the diffusion of tritiated water) was 1‐35 X 10(‐3) cm/sec at 25 degrees C. The activation energy was 10 kcal/mole, and the water permeability was not affected by phloretin or parachloromercuribenzoate. 4. It is concluded that the urea and water permeabilities of the chicken erythrocyte membrane are similar to those of a non‐porous bimolecular phospholipid membrane. 5. Like the red cells of other animal species the chicken red cell membrane contains an anion transport system, mediating a rapid exchange of chloride across the cell membranes. The pH dependence, temperature dependence, and sensitivity to inhibitors were similar to the properties of the anion transport system found in mammalian red cells. Our study shows, therefore, that the transport system offers a highly specific pathway to the exchange of anions, without presenting an inspecific leak to the permeation of water and urea.
Pragmatic Change of Politeness Request Strategies in Arabic among Saudi Arabian Bilingual Adults

This study examines the effect of l2 on L1 at the pragmatic level. Speech acts are the most revealing differences between languages from a pragmatic and linguistic perspective. This study investigates and compares the differences and similarities between request politeness strategies that bilingual Saudi speakers—who have been in the UK for two years—share with monolingual Saudi speakers and British speakers. The aim is to discover if learning English and engaging with English speakers everyday can change the way Arabic speakers from Saudi Arabia speak in their first language, specifically request politeness strategies. The study helps gain insights into the l2 effects on L1 at the pragmatic level. The question addressed in this study is—does learning English and living in an English-speaking country—Britain for two years or more—change the politeness strategies used to make a request by Saudi Arabic speakers in their first language? If it does change, how does it change? The analysis applied here is derived from Scollon and Scollon’s ( [1995]2001) politeness theory and Watts' theory (2003). Results show that Bilingual Saudis expressed a greater capacity to apply numerous techniques in the same settings as in situations 2, 4, 5, 6 while the reactions of the members involved techniques such as, direct techniques, conventional indirect techniques and non-conventional direct strategies. In a comparison undertaken amongst the bilingual Saudis, the native Saudis and the British, it was found that the fist resembled the second category more than the British.
Insomnia and hypersomnia associated with depressive phenomenology and comorbidity in childhood depression.

STUDY OBJECTIVES To examine sleep disturbance (insomnia and hypersomnia) and associated clinical profiles among depressed children and adolescents in terms of illness history, depressive severity, depressive phenomenology, and psychiatric comorbid disorders. DESIGN Clinical profiles from standardized clinical evaluations were compared. SETTING Twenty-three mental health facilities in Hungary between April 2000 and December 2004. PATIENTS AND MEASUREMENTS Five hundred fifty-three children with a current episode of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition major depressive disorder: 55% were boys, mean age was 11.7 years (SD = 2.0, range = 7.3-14.9), and 94% were Caucasian. Sleep and depressive symptoms were assessed with the Interview Schedule for Children and Adolescents-Diagnostic Version. INTERVENTIONS N/A. RESULTS Of the total sample, 72.7% had sleep disturbance: 53.5% had insomnia alone, 9.0% had hypersomnia alone, and 10.1% had both disturbances. Depressed girls were more likely to have sleep disturbance than boys (77.0% vs 69.2%, p < .05), but age had no significant effects. Compared with children without sleep disturbance, sleep-disturbed children were more severely depressed and had more depressive symptoms and comorbid anxiety disorders. Across sleep-disturbed children, those with both insomnia and hypersomnia had a longer history of illness, were more severely depressed, and were more likely to have anhedonia, weight loss, psychomotor retardation, and fatigue than were those with either insomnia or hypersomnia. CONCLUSION Clinical profiles differ between depressed children without and with sleep disturbance, with those presenting insomnia plus hypersomnia being most severely depressed. Differentiating depressed children with different sleep disturbances may have important implications for research efforts on the etiology and therapeutics of child depression.
The Belt and Road Initiative: What Is in It for China?

China's outbound investment exceeded inbound investment for the first time in 2015. In years leading up this transition, a maturing demographic transition alongside slowing internal migration and diminishing returns to physical capital investment, all had a role in China's diminished competitiveness in lowâ€ wage manufactured exports and the fading of the related growth model. In that context, the 2013 launch of the Belt and Road Initiative (BRI) took place in two stages in two developing countries, Kazakhstan and Indonesia. These launch choices, and the BRI in general are herein elaborated in terms of economic history, geography, and demography. The BRI in turn is considered to be aiming to foster the ongoing development of China, and in doing so also seeks to instigate new era development opportunity for other developing countries. One facilitation channel for the latter is China's concept of â€œpatient capital,â€ essentially concessional capital, or foreign aid. For China that offers a means via which to internationalise the financial sector and also the Renminbi. Lessons from China's own use of foreign aid and economic development hence serve as an important reference for ongoing scoping of the shape and trajectory of the BRI. To that end, this article sheds light on what is in the BRI for China.
Stroke, vascular risk factors and depression

Background Stroke, hypertension and diabetes are common in older Caribbean-born populations in the UK who may be at risk of depression secondary to vascular disease. Aims We examined the association between stroke, vascular risk factors and depression in a community-based Caribbean-born population aged 55–75 years. Method Vascular risk factors were identified by interview, examination and blood tests. Depression was categorised using the Geriatric Depression Scale. Disablement was assessed as a potential mediating factor. Results Physical illness and disablement were strongly associated with depression, independent of disablement. Previous stroke was associated with depression, independent of disablement. No vascular risk factors were associated with depression. Conclusions The risk of depression associated with stroke was not explained by disablement. However, the hypothesis that vascular risk factors are important in the genesis of depression was not supported.
New Frontiers in the Future of Aging: From Successful Aging of the Young Old to the Dilemmas of the Fourth Age

We review research findings on the oldest old that demonstrate that the fourth age entails a level of biocultural incompleteness, vulnerability and unpredictability that is distinct from the positive views of the third age (young old). The oldest old are at the limits of their functional capacity and science and social policy are constrained in terms of intervention. New theoretical and practical endeavors are required to deal with the challenges of increased numbers of the oldest old and the associated prevalence of frailty and forms of psychological mortality (e.g., loss of identity, psychological autonomy and a sense of control). Investigation of the fourth age is a new and challenging interdisciplinary research territory. Future study and discussion should focus on the critical question of whether the continuing major investments into extending the life span into the fourth age actually reduce the opportunities of an increasing number of people to live and die in dignity.
Cystatin C for early detection of acute kidney injury after laparoscopic partial nephrectomy

Introduction and Objectives: Mortality due to AKI has not changed significantly over the past 50 years. This is due in part to failure to detect early AKI and to initiate appropriate therapeutic measures. There is therefore a need to identify biomarkers that would improve the early detection of AKI. The objective of this study was to assess whether cystatin C levels obtained at specific timepoints during laparoscopic partial nephrectomy (PN) could be early predictors of AKI. Materials and Methods: Twenty-five patients underwent laparoscopic PN for organ-confined tumors. All procedures were performed by two surgeons in a single institution. Plasma samples were collected preoperatively, and post-unclamping at 5, 20, 120 min and on the day following surgery. Plasma cystatin C was measured by enzyme-linked immunosorbent assay. Correlation between levels of cystatin C and other parameters of interest were assessed in order to define cystatin C ability to predict AKI and loss of renal function following laparoscopic PN. Results: The mean baseline eGFR was 93 ml/min/1.73 m2. Warm ischemia time varied between 16 and 44 min. Post-operative day 1 (POD1) cystatin C levels compared to baseline were increased in 13 (52%) of the patients. There was a high correlation between the difference of POD 1 and baseline value, and eGFR in the immediate postoperative period (r = −0.681; P = 0.0002) and at 12-month follow-up (r = −0.460, P = 0.048). However, the variation in cystatin C levels at earlier timepoints were not associated to AKI nor renal function. Conclusions: High increase in POD 1 cystatin C levels from baseline may help identify patients with AKI and those at higher risk of chronic kidney disease, following laparoscopic PN.