Miracle-dz/UniFAR-FTUs huggingface dataset:
Low parental awareness about energy (calorie) recommendations for children’s restaurant meals: findings from a national survey in the USA

Abstract Objective To assess parental awareness of per-meal energy (calorie) recommendations for children’s restaurant meals and to explore whether calorie awareness was associated with parental sociodemographic characteristics and frequency of eating restaurant food. Design Cross-sectional online survey administered in July 2014. Parents estimated calories (i.e. kilocalories; 1 kcal=4·184 kJ) recommended for a child’s lunch/dinner restaurant meal (range: 0–2000 kcal). Responses were categorized as ‘underestimate’ (<400 kcal), ‘accurate’ (400–600 kcal) and ‘overestimate’ (>600 kcal). Confidence in response was measured on a 4-point scale from ‘very unsure’ to ‘very sure’. Logistic regressions estimated the odds of an ‘accurate’ response and confident response (‘somewhat’ or ‘very sure’) by parental sociodemographic characteristics and frequency of eating from restaurants. Sampling weights based on demographics were incorporated in all analyses. Setting USA. Subjects Parents (n 1207) of 5–12-year-old children. Results On average, parents estimated 631 (se 19·4) kcal as the appropriate amount for a 5–12-year-old child’s meal. Thirty-five per cent answered in the accurate range, while 33·3 and 31·8 % underestimated and overestimated, respectively. Frequent dining at restaurants, lower income and urban geography were associated with lower odds of answering accurately. Parents’ confidence in their estimates was low across the sample (26·0 % confident) and only 10·1 % were both accurate and confident. Conclusions Parent education about calorie recommendations for children could improve understanding and use of menu labelling information in restaurants. Targeted strategies are recommended to ensure that such efforts address, rather than exacerbate, health disparities.
A randomized phase III study of 72 h infusional versus bolus bleomycin in BEP (bleomycin, etoposide and cisplatin) chemotherapy to treat IGCCCG good prognosis metastatic germ cell tumours (TE-3)

Background Bleomycin is an integral part of combination chemotherapy in germ cell tumours. Pulmonary toxicity often necessitates drug cessation and death occurs in 1%-2% of patients. A continuous infusion of bleomycin might reduce lung toxicity when compared with the conventional weekly boluses given as part of standard BEP chemotherapy. Patients and methods A phase 3 trial was conducted based on 212 men with IGCCCG good prognosis metastatic germ cell tumours with 1 : 1 randomization. They were stratified for age, smoking history and renal function. Patients received either conventional BEP with weekly bleomycin (30 000 units/week i.v. bolus) or as a 90 000 unit infusion on day 1 over 72 h. The primary endpoint was CT assessed lung toxicity, secondary endpoints included progression-free survival (PFS), changes in lung function testing and quality of life. Repeated measures mixed effects model was used to analyse the data. Results CT assessed lung toxicity for the infusional and conventional arm patients were respectively 80% versus 62% at the end of treatment and 54% versus 51% at 1-year post-treatment. There was no significant difference between the two arms for CT assessed lung toxicity (estimated regression coefficient = 1.4, 95% CI: -0.36, 3.16). Older patients had higher toxicity (coefficient = 4.81, 95% CI: 3.04, 6.58). Lung toxicity increased after 1 cycle and peaked at end of treatment (P ≤ 0.002) and then declined. Lung function testing did not predict for subsequent lung damage. The median follow-up was 2.5 years. Two-year PFS rate (infusional: 93%, conventional: 94%; hazard ratio =0.91, 95% CI: 0.33, 2.52) was similar. Cough (P = 0.002) but not shortness of breath (P ≥ 0.09) was associated with bleomycin toxicity. Conclusions Infusional bleomycin has no advantage over standard administration. It supports abandoning routine pulmonary function testing, instead the presence of cough should be sought and the early use of CT scanning of the chest to evaluate potential lung toxicity is preferred.
Risk factors and a prognostic score for survival after autologous stem-cell transplantation for relapsed or refractory Hodgkin lymphoma

Background Novel agents are changing the treatment of relapsed or refractory Hodgkin lymphoma (HL). Nevertheless, high-dose chemotherapy and autologous stem-cell transplantation (ASCT) are considered standard of care in eligible patients. To identify patients who could benefit most from novel therapeutic approaches, we investigated a comprehensive set of risk factors (RFs) for survival after ASCT. Methods In this multinational prognostic multivariable modeling study, 23 potential RFs were retrospectively evaluated in HL patients from nine prospective trials with multivariable Cox proportional hazards regression analyses (part I). The resulting prognostic score was then validated in an independent clinical sample (part II). Results In part I, we identified 656 patients treated for relapsed/refractory HL between 1993 and 2013 with a median follow-up of 60 months after ASCT. The majority of potential RFs had significant impact on progression-free survival (PFS) with hazard ratios (HR) ranging from 1.39 to 2.22. The multivariable analysis identified stage IV disease, time to relapse ≤3 months, ECOG performance status ≥1, bulk ≥5 cm and inadequate response to salvage chemotherapy [<partial remission by computed tomography (CT)] as significant and non-redundant RFs for PFS. A risk score composed of these equally weighed RFs was significantly prognostic for PFS (HR = 1.67 for each additional RF; P < 0.0001). Validation in an independent sample of 389 patients treated in different clinical settings with evaluation of response to salvage therapy by functional imaging instead of CT confirmed the excellent discrimination of risk groups and significant prognostication of PFS and overall survival (OS) after ASCT (HR = 1.70 and HR = 1.63, respectively; P < 0.0001). Conclusions Based on this large study (n = 1045), precise and valid risk prognostication in HL patients undergoing ASCT can be achieved with five easily available clinical RFs. The proposed prognostic score hence allows reliable stratification of patients for innovative therapeutic approaches in clinical practice and future trials. Registered trials GHSG HD10 NCT00265018, HD11 NCT00264953, HD12 NCT00265031, HD13 ISRCTN63474366, HD14 ISRCTN04761296, HD15 ISRCTN32443041 and HDR2 NCT00025636.
Evaluation Of The Anti-Inflammatory, Analgesic And Antimicrobial Activities Of Bark Of Afzelia africana

Afzelia africana Smith (Caesalpiniaceae) is a perennial tree which occurs in many parts of Africa where it is used as food and widely employed in traditional medicine practice. Acute toxicity studies in mice established an oral LD50 greater than 5,000 mg/kg for bark methanolic extract. The extract and fractions (5 and 10 mg/ear; 200 and 400 mg/kg) inhibited topical edema induced by xylene in the mouse ear and significantly (P Pseudomonas aeruginosa, Escherichia coli, Salmonella typhi ), fungus ( Aspergillus niger ) and yeast ( Candida albicans ). B. subtilis was more susceptible than Staph. aureus . These findings suggest that the bark of this plant possess anti-inflammatory, analgesic and antibacterial properties which justify the ethnomedicinal uses of the plant in the treatment of inflammatory conditions, pain and infections. Keywords : Afzelia africana, bark, anti-inflammatory, analgesic, antimicrobial Nigerian Journal of Natural Products and Medicine Vol. 11 2007 pp. 48-52
Progress towards elimination of trans-fatty acids in foods commonly consumed in four Latin American cities

Abstract Objective To assess progress towards the elimination of trans-fatty acids (TFA) in foods after the 2008 Pan American Health Organization (PAHO) recommendation of virtual elimination of TFA in Latin America. Design A descriptive, comparative analysis of foods that were likely to contain TFA and were commonly consumed in four cities in Latin America. Setting San José (Costa Rica), Mexico City (Mexico), Rio de Janeiro (Brazil), Buenos Aires (Argentina). Subjects Foods from each city were sampled in 2011; TFA content was analysed using GC. TFA of selected foods was also monitored in 2016. Results In 2011–2016, there was a significant decrease in the content of TFA in the sampled foods across all sites, particularly in Buenos Aires (from 12·6–34·8 % range in 2011–2012 to nearly 0 % in 2015–2016). All sample products met the recommended levels of TFA content set by the PAHO. TFA were replaced with a mixture of saturated and unsaturated fats. Conclusions Our results indicate a virtual elimination of TFA from major food sources in the cities studied. This could be due to a combination of factors, including recommendations by national and global public health authorities, voluntary and/or mandatory food reformulation made by the food industry.
T‐cell lymphomas in adults: A clinicopathological study of eighteen cases

Eighteen cases of adult T‐cell lymphoma have been studied with respect to clinical presentation, response to treatment, histology, enzyme histochemistry, immunocytochemistry, and gene rearrangement. Seven cases (39 per cent) presented at extra‐nodal sites, and the age range was from 18 to 79. Treatment was with combination chemotherapy in most cases, and 11 of the 18 patients died within the three year follow‐up period. The lymphomas were classified morphologically into six types; T‐lymphoblastic lymphoma (TLL), angioimmunoblastic lymphadenopathy (AIL)‐like T‐cell lymphoma, T‐zone lymphoma, pleomorphic mixed medium and large cell T‐cell lymphoma (PMMLC), pleomorphic large cell T‐cell lymphoma (PLC), and monomorphic large cell T‐cell lymphoma (MLC). Enzyme histochemistry was found to be of limited value in the identification of T‐cell lymphomas. Immunocytochemistry showed a degree of correlation between the immunological profile and morphology, with cases in the PLC and MLC groups showing limited expression of T‐cell antigens. Re‐arrangement of the β chain of the T‐cell receptor gene was detected in 12 of the 14 cases studied, and all showed germ‐line immunoglobulin genes. The study emphasizes the varied morphological and clinical appearances of adult T‐cell lymphoma.
Over‐expression of polycomb group protein EZH2 relates to decreased expression of p16INK4a in cholangiocarcinogenesis in hepatolithiasis

Polycomb group protein EZH2 and Bmi1 are reportedly involved in the progression of malignant tumours. We examined the participation of EZH2 in multi‐step cholangiocarcinogenesis in hepatolithiasis with respect to tumour suppressor gene p16INK4a. We examined 20 hepatolithiatic livers with intrahepatic cholangiocarcinoma (ICC) and 10 histologically normal livers. Neoplastic biliary lesions were classified into biliary intraepithelial neoplasm (BilIN‐1, 2 and 3) and invasive carcinoma. We selected 15 foci of invasive carcinoma, 8 BilIN‐3 (carcinoma in situ), 12 BilIN‐2 (high‐grade dysplasia), 32 BilIN‐1 (low‐grade dysplasia) and 37 non‐neoplastic biliary epithelia from these livers. Expression of p16INK4a, EZH2 and Bmi1 were surveyed in these foci. P16INK4a promoter methylation was examined in microdissected tissues. Taking advantage of two cell lines of CC (HuCTT‐1 and TFK‐1) and small interfering RNA (siRNA), the effects of the knockdown of EZH2 on p16INK4a methylation of CC cells were examined. Expression of p16INK4a, which was frequent in BilIN1, was decreased in BilIN‐2/3 and invasive carcinoma, while EZH2 expression showed step‐wise increase from BilIN‐1, ‐2 and ‐3 to invasive carcinoma (p < 0.01). P16INK4a promoter hypermethylation was related to aberrant expression of EZH2. The knockdown of EZH2 in cultured CC cells decreased p16INK4a methylation and decreased binding of EZH2 to the p16INK4a gene promoter. The latter suggested that direct binding of EZH2 is involved in the regulation of the p16INK4a gene. Our data suggest that over‐expression of EZH2 may induce hypermethylation of p16INK4a promoter followed by decreased expression of p16INK4a in the multi‐step cholangiocarcinogenesis through intraepithelial neoplasm in hepatolithiasis. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Consent for blood transfusion: Do patients understand the risks and benefits?

Blood transfusion is a frequent medical intervention in hospitals. The benefits of, risks of and alternatives to blood transfusions are not consistently understood by patients. The objective of this study was to assess gaps in knowledge and comfort with the current process of consenting patients for blood transfusions. A standardised video regarding the risk and benefits of blood transfusions was developed and feedback regarding this tool was assessed.
Can the FIGO 2000 scoring system for gestational trophoblastic neoplasia be simplified? A new retrospective analysis from a nationwide dataset

Background Worldwide introduction of the International Fedaration of Gynaecology and Obstetrics (FIGO) 2000 scoring system has provided an effective means to stratify patients with gestational trophoblastic neoplasia to single- or multi-agent chemotherapy. However, the system is quite elaborate with an extensive set of risk factors. In this study, we re-evaluate all prognostic risk factors involved in the FIGO 2000 scoring system and examine if simplification is feasible. Patients and methods Between January 2003 and December 2012, 813 patients diagnosed with gestational trophoblastic neoplasia were identified at the Trophoblastic Disease Centre in London and scored using the FIGO 2000. Multivariable analysis and stepwise logistic regression were carried out to evaluate whether the FIGO 2000 scoring system could be simplified. Results Of the eight FIGO risk factors only pre-treatment serum human chorionic gonadotropin (hCG) levels exceeding 10 000 IU/l (OR = 5.0; 95% CI 2.5-10.4) and 100 000 IU/l (OR = 14.3; 95% CI 4.7-44.1), interval exceeding 7 months since antecedent pregnancy (OR = 4.1; 95% CI 1.0-16.2), and tumor size of over 5 cm (OR = 2.2; 95% CI 1.3-3.6) were identified as independently predictive for single-agent resistance. In addition, increased risk was apparent for antecedent term pregnancy (OR = 3.4; 95% CI 0.9-12.7) and the presence of five or more metastases (OR = 3.5; 95% CI 0.4-30.4), but patient numbers in these categories were relatively small. Stepwise logistic regression identified a simplified risk scoring model comprising age, pretreatment serum hCG, number of metastases, antecedent pregnancy, and interval but omitting tumor size, previous failed chemotherapy, and site of metastases. With this model only 1 out 725 patients was classified different from the FIGO 2000 system. Conclusion Our simplified alternative using only five of the FIGO prognostic factors appears to be an accurate system for discriminating patients requiring single as opposed to multi-agent chemotherapy. Further work is urgently needed to validate these findings.
Minimal disease monitoring by QRT–PCR: guidelines for identification and systematic validation of molecular markers prior to evaluation in prospective clinical trials

Real‐time RT–PCR (QRT–PCR) is a sensitive method for the detection of minimal disease (MD) and may improve monitoring of disease status and stratification of patients for therapy. Where tumour‐specific mRNAs have not been identified, the selection of which target(s) is(are) optimal for the detection of MD remains a challenge. This reflects the heterogeneity of tumour cells, the stability of mRNAs and low‐level of transcription in cells of the normal haemopoietic compartments. The aim of this study was to establish for the first time guidelines for the systematic prioritization of potential markers of MD detected by QRT–PCR prior to evaluation in multicentre prospective clinical outcome studies. We combined microarray analysis, ESTs gene expression profiles, improved probe‐sets sequence annotation, and previously described standard operating procedures for QRT–PCR analysis to identify and prioritize potential markers of MD. Using this methodology, we identified 49 potential markers of MD in neuroblastoma (NB), of which 11 were associated with neuronal function. We found that, in addition to TH, Phox2B and DCX mRNA may be useful targets for the detection of MD in children with NB. This same strategy could be exploited to select MD markers of other solid tumours from the large number of potential targets identified by microarray gene expression profiles. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
Prevalence of prediabetes and modifiable factors in an ethnic group of Mexico: the Comcáac Project

Abstract Objective To determine the prevalence of and modifiable factors associated with prediabetes in the Comcáac Indians. Design Cross-sectional study where prediabetes was defined using fasting plasma glucose, 2 h plasma glucose and glycated Hb (HbA1c). Physical, anthropometric and biochemical measurements, medical record, socio-economic, dietary and physical activity information were collected. The modifiable factors associated with prediabetes were assessed using multiple logistic regression. Settings Comcáac Indian communities of Punta Chueca and El Desemboque, Sonora, Mexico. Subjects Adults (n 227) aged 20 years or older. Results The sex- and age-adjusted prevalence (95 % CI) of prediabetes was 47·1 (40·8, 53·5) % in the overall population; age-adjusted prevalence was 47·3 (35·6, 59·0) % in men and 46·7 (39·1, 54·3) % in women. The modifiable factors associated with a risk of prediabetes (OR; 95 % CI) were light-intensity physical activity (per 1 h/week increase: 1·04; 1·01, 1·07) and insulin resistance (homeostasis model assessment of insulin resistance score >6·1 v. <4·1: 4·62; 1·37, 15·51). Increased consumption of a traditional dietary pattern based on fish and seafood, low-fat cereals, fruits and vegetables was a protective factor (0·49; 0·31, 0·79). All variables were modelled together and adjusted for age and sex. Conclusions The high prediabetes prevalence found in the Comcáac community is alarming because it represents a large number of people who are at risk for type 2 diabetes. The identification of modifiable factors associated with prediabetes that are specific to this population may be useful for designing effective strategies to prevent prediabetes.
Concerns about hypoglycemia in India: The Diabetes Attitudes Wishes and Needs (DAWN2) study

Abstract Hypoglycemia is an important complication of diabetes management, associated with both acute and chronic medical implications. Hypoglycemia is also associated with significant psychosocial stress. The recently conducted second Diabetes Attitudes Wishes and Needs study (DAWN2) explores this aspect of hypoglycemia. This brief communication discusses data related to worry about hypoglycemia in the Indian cohort of people with diabetes and family members. It suggests strategies to reduce this avoidable stress.
Where are the low-calorie sweeteners? An analysis of the presence and types of low-calorie sweeteners in packaged foods sold in Brazil from food labelling

Abstract Objective Studies have shown that consumption of low-calorie sweeteners (LCS) may be associated with harmful health effects. The current study investigated the presence and types of LCS added to packaged foods. Design Cross-sectional study analysing the presence and types of LCS in the ingredients lists of packaged foods sold at a major Brazilian supermarket. To identify types of LCS allowed for use in foods in Brazil, current legislation was consulted. Data were organised and analysed through descriptive statistics, presenting simple and relative frequencies of LCS presence categorised by food group. Setting Supermarket in Florianópolis, southern Brazil. Subjects Packaged food products (n 4539) from eight food groups. Results One or more LCS were found in 602 (13·3 %) of the packaged foods analysed. There were 1329 citations of LCS among these foods, with a mean of 2·2 sweeteners per food. Groups with the highest frequency of foods containing LCS were: products with energy derived from carbohydrates and fats (25·0 %); milk and dairy products (11·7 %); bakery products, cereals, legumes, roots and tubers (11·2 %); and fruits, juices, nectars and fruit drinks (8·3 %). Conclusions There was high prevalence of packaged foods with LCS, especially in food groups that form the basis of the Brazilian diet. The study was the first to extensively analyse the presence and types of LCS in packaged foods available for sale in a Brazilian supermarket and can be useful to monitor the use of LCS in these foods, as well as to support future changes in legislation to label sugars.
Serological study of Leptospirosis in central Nepal

Background: Leptospirosis, an infectious disease caused by spirochetes of the genus Leptospira, is the most widespread zoonosis in the world. Humans acquire infection through contact with the urine of infected or carrier animals, either directly or through contaminated water or soil. There are only few reports documenting the serological evidence of leptospirosis in Nepal. Thus, present study aims to determine the status of leptospirosis in central Nepal. Material and Methods: A descriptive cross sectional study was conducted in 1266 patients suspected of leptospirosis in Chitwan Medical College Teaching Hospital for a period of two years. Blood samples collected from the patients were processed for qualitative detection of leptospiral IgM antibody by ELISA (Enzyme linked immunosorbent assay). Results: Of the 1266 samples subjected to ELISA, seropositivity was seen in 61 samples (4.8%) with the highest rate observed in the autumn season (63.9%) followed by summer season (21.3%). Majority (39.3%) of the seropositive individuals were agricultural workers. Leptospirosis was more common in males and in the people of 16-30 years. Conclusion: Leptospirosis is common in central Nepal. Epidemiological surveillance and laboratory capacity across the region need strengthening to determine its true prevalence in the community.
SmgGDS is up‐regulated in prostate carcinoma and promotes tumour phenotypes in prostate cancer cells

SmgGDS is a guanine nucleotide exchange factor with the unique ability to activate multiple small GTPases, implicating it in cancer development and progression. Here, we investigated the role of SmgGDS in prostate cancer by studying the expression of SmgGDS in benign and malignant prostatic tissues. We also probed SmgGDS function in three prostate carcinoma cell lines using small interfering RNA (siRNA). Immunohistochemical analysis revealed that SmgGDS levels were elevated in prostatic intraepithelial neoplasia (PIN), prostate carcinoma, and metastatic prostate carcinoma. In addition, expression of SmgGDS positively correlated with that of cyclooxygenase‐2 (COX‐2), a protein believed to promote the development of prostate carcinoma. Reduction of SmgGDS expression in prostate carcinoma cells inhibited proliferation and migration, irrespective of androgen receptor status. These effects were accompanied by a reduction in COX‐2 expression and in activity of NF‐κB, a known regulator of COX‐2. Taken together, these findings suggest that SmgGDS promotes the development and progression of prostate cancer, possibly associated with NF‐κB‐dependent up‐regulation of COX‐2. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.