Miracle-dz/UniFAR-FTUs huggingface dataset:
Currently Used Markers for CTC Isolation - Advantages, Limitations and Impact on Cancer Prognosis

Circulating tumor cells (CTC) released from primary tumor tissues into the bloodstream or lymphatic vessels are able to colonize distant organs giving rise to metastasis, which is the major factor contributing to poor survival of cancer patients. Thus, molecular characterization of CTC is thought to hold the key to enable an early clinical assessment of metastasis and to lead to improved therapeutic measurements. A number of markers have been described for the detection of CTC. However, for CTC isolation from blood samples only six markers have been used up to now. CTC isolation is a prerequisite of a better molecular characterization of these rare cells. Thus, we have focused on these six markers. Current approaches to capture CTC by specific marker molecules are still complex, and characterized by poor yield and low purity. This mini-review, which is not meant to be exhaustive, is specifically focused on what markers have been used for isolation of CTCs derived from solid cancers and on what are the advantages, limitations and impact of these markers. It aims to attract the interest of oncologists to this new exciting research field and to help them to critically review the wide variety of reported markers with sometimes conflicting results, in order to find better criteria how to identify references expected to provide reliable clinical information. MEDLINE and PubMed databases were searched using the keywords “circulating tumor cells”, “CTC isolation” and “surface markers”. Reviews, casecontrolled studies and reports published from 1989 through 2011 in English were analyzed, and the six markers EpCAM, E phB4, E GFR, C EA, H ER2 and MUC-1 were chosen for further discussion.
ASSESSMENT OF KETAMINE EFFECT AS ADJUVANT TO MORPHINE IN POST- OPERATIVE PAIN REDUCTION IN DONOR KIDNEY TRANSPLANTED

Background: Morphine is a strong analgesic agent being used in acute pain but adverse effects may lead to its discontinuation before sufficient pain relief is obtained. Ketamine is an anti-nociceptive drug which blocks NMethyl-D-Aspartate receptors and can modulate acute pain. In this study, ketamine effect as an adjuvant with morphine for post-operative pain management is evaluated. Method: In a double blind randomized clinical trial, 50 kidney donors undergoing nephrectomy and receiving morphine as analgesics were enrolled. Patients were divided into two groups receiving ketamine (ketamine group) and saline serum (placebo group). Post-operative pain was assessed by measuring cumulative morphine consumption and visual analog scale pain scores were assessed in 48 hours duration after surgery. Results: Pain intensity and cumulative morphine consumption were lower and sedation score was higher in the ketamine group. Both groups were similar regarding the side effects.
Analysis of lingual en masse retraction combining a C-lingual retractor and a palatal plate.

OBJECTIVES To analyze the results of employing en masse retraction of the maxillary anterior dentition using palatal temporary skeletal anchorage devices (TSADs) as the exclusive source of anchorage. MATERIALS AND METHODS A retrospective clinical investigation supported by preliminary case reports was performed comparing pretreatment cephalometric radiographs with those taken after en masse retraction of the six anterior teeth. The sample consisted of 35 nongrowing patients with an average age of 22.9 years. The average retraction period was 10 months (range, 6-15 months). No brackets or bands were placed on the posterior dentition during retraction. A total of 35 C-palatal plates (C-plates) were used as the only source of anchorage for maxillary anterior retraction with the C-lingual retractor (C-retractor), thereby eliminating the need for bonded or banded anchor teeth. The cephalometric radiographs were analyzed for differences between pretreatment and postretraction variables that included skeletal, dental, and soft tissue relationships. RESULTS Significant incisor and canine retraction was achieved in all patients, and the upper posterior teeth did not show significant mesial drifting during the retraction period. According to the length of the lever arm of the C-retractor, tooth movement showed different directions. CONCLUSIONS En masse retraction of the six anterior teeth with good torque control and effective intrusion is possible using palatal TSADs as the only source of anchorage.
Orthostatic hypotension in Parkinson's disease

SUMMARY Orthostatic hypotension (OH) is a frequent non-motor symptom in Parkinson’s disease (PD), affecting between 22.9 and 38.4% of patients. In PD, OH is related to an increased risk of falls, and possibly to cognitive dysfunction and increased mortality. These data emphasize the importance of its prompt recognition and treatment. OH is related to pre- and post-ganglionic adrenergic denervation, but other factors, such as drugs, heat, meals or alcohol intake, might also induce or aggravate it. Evidence about the efficacy and safety of pharmacological or nonpharmacological strategies for OH treatment in PD is weak. Nonpharmacological measures include liberal addition of salt to the diet, exercise, compression stockings or physical maneuvers. Severe cases may be treated with midodrine or fludrocortisone. Some results suggest that droxidopa and fipamezole may be effective treatments. We finish this review article by discussing the most important unanswered questions about PD-related OH, which may be the f.
Teaching and learning challenges facing primary school teachers of students from non-English speaking backgrounds

i! Acknowledgements ii! Chapter 1: Introduction 1! Chapter 2: Literature Review 8! Chapter 3: Methodology 26! Chapter 4: Findings 37! Chapter 5: Discussion of Findings 69! Chapter 6: Conclusion 86! Recommendations 94! References 98! Appendices 108
Rates of induced abortion in Denmark according to age, previous births and previous abortions

Background: Whereas the effects of various socio-demographic determinants on a woman’s risk of having an abortion are relatively well-documented, less attention has been given to the effect of previous abortions and births. Objective: To study the effect of previous abortions and births on Danish women’s risk of an abortion, in addition to a number of demographic and personal characteristics. Data and methods: From the Fertility of Women and Couples Dataset we obtained data on the number of live births and induced abortions by year (1981-2001), age (16-39), county of residence and marital status. Logistic regression analysis was used to estimate the influence of the explanatory variables on the probability of having an abortion in a relevant year. Main findings and conclusion: A woman’s risk of having an abortion increases with the number of previous births and previous abortions. Some interactions were was found in the way a woman’s risk of abortion varies with calendar year, age and parity. The risk of an abortion for women with no children decreases while the risk of an abortion for women with children increases over time. Furthermore, the risk of an abortion decreases with age, but relatively more so for women with children compared to childless women. Trends for teenagers are discussed in a separate section.
Exclusive breastfeeding and related antecedent factors among lactating mothers in a rural community in Southwest Nigeria

This study explored the antecedent factors influencing the practice of exclusive breast feeding (EBF) among lactating mothers in Ayete, a rural community in Southwest Nigeria. A three-stage random sampling technique was used to select 410 mothers of newborns and infants less than six months from households. A pretested semi-structured questionnaire which included a 14-point knowledge scale was used for data collection. Data were analyzed using descriptive statistics, Chi-square test and analysis of variance (ANOVA). Mean age was 27.4±5.9 years and 67.1% respondents were aware that EBF should be initiated immediately after birth. Mean knowledge score on EBF was 8.2±2.9. Age, educational level and occupation were significantly associated with knowledge of EBF (p<0.05). Main perceived challenges associated with EBF were loss of essential nutrients by mothers (87.6%) and inducement of hunger (26.2%). Only 10.2% of respondents were practicing EBF as at the time of the study. Reasons for not practicing EBF included baby needs herbs for strength and vitality (31.3%), baby needed water to quench thirst (23.9%) and non-satisfaction with breast milk alone (20.8%). Practice of EBF was significantly more among respondents earning less than N5000.00 monthly (p<0.05). Continuous sensitization activities are needed to promote breast feeding among lactating mothers. Key words: Exclusive breastfeeding, lactating mothers, antecedent factors.
Cigarette and e-cigarette dual use and risk of cardiopulmonary symptoms in the Health eHeart Study

E-cigarettes are promoted as healthier alternatives to conventional cigarettes. Many cigarette smokers use both products. It is unknown whether the additional use of e-cigarettes among cigarette smokers (dual users) is associated with reduced exposure to tobacco-related health risks. Cross-sectional analysis was performed using baseline data from the Health eHeart Study, among English-speaking adults, mostly from the United States. Cigarette use (# cigarettes/day) and/or e-cigarette use (# days, # cartridges, and # puffs) were compared between cigarette only users vs. dual users. Additionally, we examined cardiopulmonary symptoms/ conditions across product use: no product (neither), e-cigarettes only, cigarettes only, and dual use. Among 39,747 participants, 573 (1.4%) reported e-cigarette only use, 1,693 (4.3%) reported cigarette only use, and 514 (1.3%) dual use. Dual users, compared to cigarette only users, reported a greater median (IQR) number of cigarettes per day, 10.0 (4.0–20.0) vs. 9.0 (3.0–15.0) (p < .0001), a lower (worse) median (IQR) SF-12 general health score, 3.3 (2.8–3.8) vs. 3.5 (2.8–3.9) (p = .0014), and a higher (worse) median (IQR) breathing difficulty score in the past month, 2.0 (1.0–2.0) vs. 1.0 (1.0–2.0) (p = .001). Of the 19 cardiopulmonary symptoms/ conditions, having a history of arrhythmia was significantly different between cigarette only users (14.2%) and dual users (17.8%) (p = .02). In this sample, dual use was not associated with reduced exposure to either (i) cigarettes, compared to cigarette only users or (ii) e-cigarettes, compared to e-cigarette only users. E-cigarette only use, compared to no product use, was associated with lower general health scores, higher breathing difficulty scores (typically and past month), and greater proportions of those who responded ‘yes’ to having chest pain, palpitations, coronary heart disease, arrhythmia, COPD, and asthma. These data suggest the added use of e-cigarettes alone may have contributed to cardiopulmonary health risks particularly respiratory health risks.
Effect of Lagenaria siceraria fruit extract (Bottle gourd) on hepatotoxicity induced by antitubercular drugs in albino rats

Background: Anti TB drug induced hepatotoxicity has higher incidence in Indian population [11.5%] than western population [4.5%]. Antitubercular drug induced hepatotoxicity is mediated through oxidative and free radical damage to hepatocytes. Lagenaria siceraria [Bottle Gourd] is reported to have antioxidant and hepatoprotective activity. Hence in the present study we tested hepatoprotective and antioxidant activity of fruit extract of L. Siceraria in anti tubercular drug induced hepatotoxicity. Methods: We administered antitubercular drugs alone and in combination with fruit extract of Lagenaria siceraria (EELS 100mg/kg and EELS 200mg/kg) in healthy albino rats by oral route for 15 days. On 16th day blood collection for biochemical analysis is done by cardiac puncture. Biochemical markers used are serum transaminases (SGPT/SGOT), serum alkaline phosphatase [ALP], total bilirubin, total protein, superoxide dismutase [SOD] and malondialdehyde [MDA]. Liver is dissected for histopathological examinations. Results: Groups that received EELS [100 mg/kg & 200 mg/kg], in combination with anti tubercular drugs, showed significant reduction [p value <0.001] in biochemical parameters for hepatotoxicity [SGOT, SGPT, ALP, Total bilirubin, Total protein] in comparison with group that received anti tubercular drugs alone. Combined treatment of EELS [100 mg/kg & 200 mg/kg] & Anti tubercular drugs showed significant reduction in oxidative stress [SOD & MDA, p<0.001] as compared to anti tubercular drug alone. Histopathological examination of liver showed grade I & grade 0 changes in combination group while grade IV changes in group receiving anti tubercular drugs alone. Conclusion: Ethanolic extract of Lagenaria siceraria fruit possesses significant hepatoprotective and antioxidant activity in antitubercular drugs induced hepatotoxicity.
Risk Factors for Alzheimer’s Disease

Alzheimer’s disease (AD) is the most common disease in developed countries and affects more than half of the population in lowand middle-income countries. In the past decade, studies have shown that biological and sociological factors have a significant effect on the occurrence and development of AD. Among them, genetic and environmental factors, pathophysiological characteristics, and unhealthy lifestyle factors cause the neurological symptoms. Among them, the risk factors of cognitive decline in the elderly caused by lifestyle can be intervened in the early stage. If some adults can overcome these risk factors as early as possible, they can predict that they will gradually reduce their cognitive impairment over time, and the likelihood of developing AD will decrease in the future. ■
Hospital Discharge: A Descriptive Study of the Patient Journey for Frail Older People with Complex Needs

This paper reports on a descriptive study using locally available health and social care data relating to the patient journey of a cohort of frail, older people with complex health and social care needs. The study identifies contact with social care services and some health services prior to hospital admission, charts the patient journey in hospital, and provides information on discharge destinations. The findings have implications for the discharge planning process and the improvement of community care services, including intermediate care.
Inflammatory lipids as a target for therapy in the rheumatic diseases

As patients with autoimmune rheumatic diseases live longer due to improved therapies and preventive measures, death and disability from cardiovascular events are increasing. Patients with rheumatoid arthritis and systemic lupus erythematosus have an increased risk of atherosclerosis that persists even after accounting for traditional cardiac risk factors. Recent studies strongly suggest that the mechanism is due in part to increased levels of oxidized lipids (such as oxidized low density lipoprotein and pro-inflammatory high density lipoproteins) which cause the inflammatory cascade that ultimately leads to plaque formation. The objective of this review is to discuss how inflammatory lipids contribute to the increased risk of atherosclerosis in rheumatoid arthritis and systemic lupus erythematosus, as well as to propose that these oxidized lipids are a rational target for therapeutic intervention in autoimmune diseases. Published literature was examined to review treatments for pro-inflammatory lipids in autoimmune diseases such as rheumatoid arthritis and systemic lupus erythematosus. In conclusion, it is possible that these oxidized lipids may also contribute to increased disease manifestations in rheumatic conditions. Several new and existing therapies, including statins and high density lipoprotein-associated protein peptide mimetics such as D-4F (apoA-1) target these oxidized lipids and may be useful in both preventing atherosclerosis and treating inflammation in patients with rheumatic diseases.
Risk Factors for Blood Loss Following Total Knee Arthroplasty

Background: Blood loss following total knee arthroplasty (TKA) is a challenging issue faced by orthopedic surgeons. Determination of risk factors for significant blood loss is a significant step toward blood management. Objectives: The aim of this study was to determine factors predicting intraoperative blood loss, postoperative drainage, and need to blood transfusion in patients undergoing TKA. Patients and Methods: In a prospective study, 96 consecutive patients who underwent primary cemented TKA were included. Intraoperative blood loss, postoperative blood drainage, and hemoglobin (Hb) drop were measured and analyzed in terms of age, sex, body mass index, and tourniquet closure time. Results: The mean age of patients was 68.4 ± 5.6 years (range, 52-75). Mean intraoperative blood loss and postoperative drainage were 147.1 ± 97.4 mL and 494.4 ± 188.1 mL, respectively. Based on a regression model, males and obese patients had significantly higher intraoperative blood loss (P < 0.05). Additionally, male sex and older age were significantly associated with more severe drop in Hb on the first postoperative day; however, there was no predictor of need for transfusion in regression analysis. Conclusions: Male sex and obesity were the risk factor for intraoperative blood loss while the elderly and male patients experienced more severe postoperative bleeding.
Attitudes of Primary Care Physicians Toward Older Drivers: A Finnish-Swedish Comparison

Finnish and Swedish general practitioners'(GPs) activities, knowledge, and attitudes related to aging and driving were compared using a mail survey to evaluate the effects of the two countries' different driver licensing policies. The hypothesis was that the existence of an obligatory medical screening system in Finland would make the Finnish GPs more active or knowledgeable concerning aging and driving than their Swedish colleagues with no experience of such a system. The survey was sent to a random sample of registered GPs who worked in primary health care centers in Sweden (n = 1,500) and in Finland (n = 1,527); 1,682 respondents completed the form and were included in final analysis. The results did not support the hypothesis: The Swedish GPs reported more activities than did their Finnish colleagues. The level of knowledge was similar in both countries, but the Finnish GPs had higher confidence in their diagnostic competence and more restrictive attitudes than did the Swedish GPs. The existence of an obligatory medical screening system hence did not make the Finnish GPs more active or knowledgeable concerning aging and driving compared to their Swedish colleagues. In contrast, it may contribute to the Finnish GPs' unrealistic confidence in their own assessment skills and in the adequacy of the present screening system in Finland.
Health Care Providers’ Perceptions of Responsibilities and Resources to Reduce Type 2 Diabetes Risk After Gestational Diabetes Mellitus

IN BRIEF Gestational diabetes mellitus (GDM) increases the risk for type 2 diabetes. This qualitative study aimed to evaluate health care providers’ perceptions of care responsibilities and resources related to reducing type 2 diabetes risk among women with previous GDM in Singapore. Health care providers acknowledged a shared responsibility. They felt that they had less understanding of compliance with long-term maintenance of lifestyle change, exacerbated further by fragmentation of follow-up care. The application of more integrated patient-centered care models, combined with greater health literacy, is urgently required in this area.
Anal and Ano-Urogenital Malformations: A Histopathological Study of “Imperforate Anus” with a Reconstruction of the Pathogenesis

Abstract Histopathological information about “anorectal malformations” is scarce and the pathogenesis still controversial. Autopsy specimens of 20 human fetuses and newborns with “main” types of the disorder were studied histologically. Supplemented with surgical-anatomical data from the literature and with information from our own and earlier embryological research in animal models as well as from recent observations on the normal development of the human perineum, the study allowed for a new reconstruction of the pathogenesis of the disorder. The histological analysis of the malformations in human fetuses and newborns showed a ventralward deviation of the anal canal as the principal deformity. Ano-urogenital communications and differently structured ectopic anocutaneous canals issued from anywhere between the bladder and the vestibular/urethral orifice (female urethra excluded) and between the orifice and the usual site of the anus, respectively, or they ended blindly, but with a suggestion of lost comm.
Association of cerebral oxygenation with estimated glomerular filtration rate and cognitive function in chronic kidney disease patients without dialysis therapy

Background A decline in estimated glomerular filtration rate (eGFR) is reportedly associated with increased prevalence rates of cognitive impairment. However, data concerning the association between the cerebral saturation of oxygen (rSO2) and cognitive function of patients with chronic kidney disease (CKD) is limited. This study aimed to (i) elucidate the clinical factors associating with cerebral rSO2 and (ii) investigate the association between cerebral rSO2 and cognitive assessment in CKD patients. Methods A total of 40 CKD patients not requiring dialysis (26 men and 14 women; mean age, 61.0 ± 2.7 years) were recruited. The numbers of patients at each CKD stage were as follows: G1, 5; G2, 8; G3a, 6; G3b, 5; G4, 11; and G5, 5. Cerebral rSO2 was monitored at the forehead using the oxygen saturation monitor INVOS 5100C. The cognitive function of each patient was confirmed using the Mini-Mental State Examination (MMSE). Results Cerebral rSO2 levels were significantly higher in CKD patients than in hemodialysis patients (63.8 ± 1.5% vs. 44.9 ± 2.2%, p < 0.001). Multiple regression analysis showed that cerebral rSO2 was independently associated with eGFR (standardized coefficient: 0.530), serum albumin concentration (standardized coefficient: 0.365), and serum sodium concentration (standardized coefficient: 0.224). Furthermore, MMSE showed a significantly positive correlation with cerebral rSO2 (r = 0.624, p < 0.001). Conclusions Cerebral rSO2 was affected by eGFR and serum albumin and sodium concentrations in CKD patients. Furthermore, cerebral rSO2 monitoring, which reflected MMSE scores, might be a useful method for assessing cognitive function in CKD patients.