Miracle-dz/UniFAR-FTUs huggingface dataset:
Gemcitabine and capecitabine in combination for advanced anthracycline and taxane pre-treated breast cancer patients: A phase II study

Abstract Aim. The aim of this study was to explore the clinical value of gemcitabine combined with capecitabine (GC) in heavily pre-treated patients with metastatic breast cancer. Material and methods. All patients had failed anthracyclines and taxanes. In 14 patients (41%), more than two metastatic sites were diagnosed with bone (68%) and liver (62%) being the most prominent. Gemcitabine (1 250 mg/m2, d1+8) and capecitabine (800 mg/m2 twice daily, d1-14) were administered according to a 3-week schedule. The majority of patients received GC as 3rd or 4th line chemotherapy for metastatic disease. Laboratory tests were done on day 1+8 in cycles. Subjective toxicity was recorded according to the NCI-CTC v. 2.0 criteria. Tumour evaluations were done every 12th week according to the RECIST criteria. The primary objective was to investigate time to progression. Secondary objectives were response rate with special focus on the proportion of patients achieving PR or SD of at least three months, toxicity and survival. Results. A total of 34 patients were enrolled. All subjects are eligible for toxicity, response and time to event analyses. Treatment was given until progressive disease, severe toxicity or until the patient wanted to withdraw. The Kaplan-Meier median time to progression was estimated to 4.3 months and the overall survival time to 13.7 months. Partial response was noted in 12 of 29 evaluable patients (41%). The best outcome amongst remaining patients was stable disease in nine (31%) or tumour progression in eight (28%). A delay of disease progression of more than three months was noted in 53% of the study population. The main side effect was granulocytopenia with 44% and 15% of patients suffering from grade 3 or grade 4 events respectively however, no neutropenic infections were observed. Pre-dominant grade 3 subjective toxicities were: fatigue (21% of patients) and hand-foot syndrome (15% of patients). Discussions. We investigated the value of the GC combination as a treatment for late stage breast cancer patients. Tumour progression was delayed and the treatment was well tolerated. We believe that the GC therapy can achieve meaningful palliation.
Oncogenic proteins new targets for chemotherapeutic agents against cancer

Summary— Over the past 10 years, more than 40 potentially oncogenic genes, termed protooncogenes, have been identified in the human genome. Little is known of the physiological role of the proteins encoded by these genes, but they seem to be involved in the reception and transmission of hormonal and other environmental information from the cell membrane to the nucleus. These proteins may acquire transforming properties when over‐expressed or if structurally altered following partial deletions or point mutations. Cytogenetic analysis shows loss of genetic material from specific chromosomal loci in many human tumors, suggesting that the absence of a functional gene at these loci may permit tumor development. The genes involved have been termed “anti‐oncogenes”. Understanding the control mechanisms of cell proliferation is essential in order to understand how cancer cells escape from this control. To this end, numerous oncogenes have been cloned, permitting the production of modified forms of oncogenic proteins and identification of the regions essential for their biological activity. Availability of large amounts of protein also allows the production of specific antibody which can be used to verify whether blockage of a given protein results in reversion of the transformed phenotype. If it can be shown that the expression of an oncogenic protein is essential for transformation, it should be possible to search for molecules that inhibit its action or which mimic the effects of an anti‐oncogene. This type of research is already well advanced for the oncogenic ras proteins, and models have been established that permit both screening for potential inhibitors and design of specific antagonists.
Use of pulmonary artery catheters in patients with acute myocardial infarction. Analysis of experience in 5,841 patients in the SPRINT Registry. SPRINT Study Group.

This study analyzes the use of PAC in a registry comprising 5,841 hospitalized patients with AMI. A total of 371 patients received PAC. In-hospital mortality was higher in patients with CHF who received PAC, while there was no difference in patients with cardiogenic shock or persistent hypotension. Mortality in patients receiving PAC was higher irrespective of the presence or absence of "pump failure. " A separate analysis of discharge summaries of 364 patients with CHF showed that PAC was used more frequently in sicker patients and that when severity of CHF was assessed, no difference in mortality was found in patients with mild or moderate CHF. We conclude that while a higher in-hospital mortality is found in patients receiving PAC, this excess is likely related to difference in severity of CHF, which had not been assessed in every individual. It is unlikely that PAC increases mortality.
Prevalence of and factors associated with obstructive sleep apnea in a cohort of adults with long duration type 1 diabetes mellitus

Chronic health conditions like diabetes and sleep disorders have been increasing. Previous research showed that diabetes and sleep disorders are interrelated. The majority of studies examining this relationship focused on type 2 diabetes. Although a relationship between sleep disorders and type 1 diabetes (T1D) has been studied, investigations have been limited to youth and small samples. We, therefore, aimed to assess the prevalence, overall and gender-specific, and correlates, of obstructive sleep apnea (OSA) risk in an adult cohort with long-standing T1D. A total of 170 individuals with T1D attending the 25-year follow-up of the Pittsburgh Epidemiology of Diabetes Complications study who completed an OSA screening tool, the Berlin Questionnaire (BQ), were included in this cross-sectional analysis. Those scoring positively on the BQ and/or reported a previous OSA diagnosis were classified as being at high OSA risk. The OSA risk prevalence was 25.9% (25.0% among men, 26.6% among women). High versus low-OSA-risk individuals differed univariately with respect to markers of obesity, systolic blood pressure, estimated glucose disposal rate, lipid profile, and smoking history, although no differences were observed in hemoglobin A1c. In the final multivariable model, adjusting for sex and diabetes duration, body mass index (BMI) (directly, p=0.01), high-density lipoprotein (HDL) (inversely, p=0.03), and smoking history (directly, p=0.04) correlated with OSA risk. In gender-specific analyses, adjusting for diabetes duration, BMI (directly, p=0.007) and HDL (inversely, p=0.03) were also associated with OSA risk in women, while diastolic blood pressure (p=0.01) and smoking history (p=0.04) were positive OSA correlates in men. Our findings suggest that the prevalence of high OSA risk in adults with long-standing T1D is comparable to that in the general population. Given that both OSA screening tools and treatment are widely available, identifying high OSA risk among individuals already burdened with a serious chronic disease is of public health importance. Indeed, modifiable risk factors were independently associated with OSA risk in this study, suggesting that the adoption of a healthier lifestyle may reduce OSA risk in T1D, improving the wellbeing and reducing the subsequent risk of further complication development. Future prospective cohorts should be conducted to explore this hypothesis.
Molds and mycotoxins in dust from water-damaged homes in New Orleans after hurricane Katrina.

UNLABELLED Dust collected in New Orleans homes mold-contaminated because of the flooding after hurricane Katrina was analyzed for molds and mycotoxins. The mycoflora was studied by cultivation and quantitative PCR for selected molds. The most commonly found mold taxa were Aspergillus, Cladosporium, and Penicillium. Verrucarol, a hydrolysis product of macrocyclic trichothecenes predominately produced by Stachybotrys spp. was identified in three dust samples by gas chromatography-tandem mass spectrometry, and sterigmatocystin (produced by various Aspergillus spp.) was found in two samples by high pressure liquid chromatography-tandem mass spectrometry. This is the first demonstration of mycotoxins in Katrina-associated dust samples. The analytical methods used represent valuable tools in further studies on bioaerosol exposure and health risks. PRACTICAL IMPLICATIONS In the aftermath of natural disasters like hurricane Katrina water-damages on infrastructure and public and private property are often associated with health risks for remediation workers and returning residents. In the case of New Orleans evaluations of health hazards, health studies, and assessments of bioaerosol have been conducted previously. However, until now mycotoxins have not been addressed. Our study shows, for the first time, the presence of mycotoxins in dust collected in houses in New Orleans mold-contaminated because of the hurricane Katrina. The results may highlight the potential health threats posed by mold aerosols in post-disaster inhabited areas.
Two distinct clinical courses of renal involvement in rheumatoid patients with AA amyloidosis.

OBJECTIVE We conducted a prospective study to investigate whether a correlation exists between the clinical course of renal involvement and the pathological findings of renal amyloidosis in patients with rheumatoid arthritis (RA). METHODS Patients with RA of more than 5 years' duration and who did not show renal manifestations were selected and received a duodenal biopsy for the diagnosis of amyloidosis. After the diagnosis of AA amyloidosis, patients received a renal biopsy, and patterns of amyloid deposition were examined. We followed the renal functions (serum levels of blood urea nitrogen and creatinine) of patients diagnosed with AA amyloidosis for 5 years. RESULTS We diagnosed 53 patients with AA amyloidosis and monitored the renal function of 38 of them for > 5 years. The histological patterns were examined; in the 38 patients there were appreciable variations in the patterns of amyloid deposition. In 27 patients, amyloid deposits were found exclusively in the glomerulus (type 1). In the other 11 patients, however, amyloid deposits were found selectively around blood vessels and were totally absent in the glomerulus (type 2). In type 1 patients with glomerular involvement, renal function deteriorated rapidly regardless of disease state; most patients received hemodialysis. In type 2 patients with purely vascular involvement, however, renal function did not deteriorate significantly. CONCLUSION In patients with RA and AA amyloidosis, 2 distinct clinical courses in terms of renal involvement were identified. It is suggested that renal function does not deteriorate when amyloid deposition is totally lacking in the glomerulus.
A conceptual framework of integrity

This article reports on the findings of a qualitative study in which the construction of integrity of some business leaders was explored. Data were gathered through ten in-depth interviews with six South African business leaders commended to be champions of integrity. A grounded-theory approach to the data analysis elicited five themes. These themes and their interrelatedness are discussed in this article and a conceptual framework of integrity is proposed. Integrity is conceptualised as a multifaceted and dynamic construct based on a moral foundation and inner drive that is managed by cognitive and affective processes manifesting various integrity-related behaviours.
Incidence and Predictors of Tuberculosis among HIV/AIDS Infected Patients: A Five-Year Retrospective Follow-Up Study

Background: Despite increased deliverance of antiretroviral therapy (ART), morbidity and mortality from TB are still predominant among HIV/AIDS infected patients in Ethiopia. Thus, current study aimed to determine magnitude and predictors of tuberculosis among cohort of HIV infected patients at Arba Minch General Hospital, Ethiopia, 2015. Methods: Hospital based retrospective follow-up study was conducted among study population which was HIV/AIDS infected individuals registered from September 2007 to 2013. The data were collected using structured data abstraction form and four ART trained nurses were used to abstract the data. The data were checked for completeness, cleaned and entered into Epi Info 7.0 and analyzed using SPSS version (IBM-21). Results were summarized by using table of frequency, graph, and measure of central tendency. Statistical significance was inferred at P-value ≤ 0.05. Adjusted odd ratio (AOR) with 95% confidence interval (CI) was used to determine predictors. Result: Four hundred ninety six patient’s charts were abstracted. Cumulative and incidence density of tuberculosis were 21.4% (95% CI: 21.3, 21.44) and 5.36 per 100 person year respectively. Cigarette smokers (AOR: 2.82, 95% CI (1.27 - 6.27)), household with family size of 3 - 4 (AOR: 2.26, 95% CI (1.14 - 4.50)), baseline WHO clinical stage III (AOR: 20.26, 95% CI (7.09 - 57.6)) and IV (AOR: 22.9, 95% CI (6.91 - 76.4)) and heamoglobin level of high incident tuberculosis cases were established among HIV infected patients and history of cigarette smoking; family size; hemoglobin level and base line WHO clinical stage were responsible for this incidence. Therefore; early initiation of HAARTas per current guideline should get stressed, and the finding that smoking was important predictors for TB in Ethiopia had obvious TB control implication which required high attention focused on fighting against cigarette smoking among HIV infected cohort.
Ethnomedicines in Antiviral Drug Discovery

This review is an attempt to portray the discovery and development of ethnomedicine and its phytophores against some important viral diseases from galenical to genomical period. Natural resource, particularly the plants and animals have been the basis of traditional treatment since the dawn of human civilization and the modern medicine (Allopathy) has gradually developed, over the years, by scientific and observational efforts from traditional practice. However, with the advent of antibiotics the role of traditional medicaments in infectious diseases was sidelined. Interestingly after the 1980’s, society realized the problem of drug resistance, emerging and reemerging pathogens, adverse drug reactions of many antimicrobials, particularly the antivirals. Hence, the lag phase for plant medicine is changing as impressive successes have been achieved with many botanicals like artemisinin, baccosides, curcumine, phyllanthins, quinghaosu, rauwolfia alkaloids, psoralens, picrosides, withanolides, steroidal lactones etc against many chronic and difficult-to-treat diseases. A whole range of chronic and lifestyle related diseases including HIV/AIDS, SARS, and Herpesvirus infection require new effective drugs. Considerable research has been carried out on pharmacognosy, chemistry, pharmacology and clinical therapeutics on Indian Ayurveda, Chinese traditional medicine, and traditional medicines of Africa in the last few decades. Many of the major pharmaceutical companies have renewed their strategies for drug development where there are no effective drugs or vaccine. Hence, many new compounds have entered the international pharmacopoeia through ethno-pharmacology and traditional medicine. Traditional knowledge-driven drug development can reduce both time and cost following a reverse pharmacology path. The automated separation techniques, highthroughput screening and combinatorial chemistry can help ethnomedicines to serve as a powerful search engine to facilitate intentional, focused and safe natural products research and to rediscover the drug discovery process. _____________________________________________________________________________________________________________
Laser Surface Scanning for Patient Registration in Intracranial Image-guided Surgery

OBJECTIVE To report our clinical experience with a new laser scanning-based technique of surface registration. We performed a prospective study to measure the calculated registration error and the application accuracy of laser surface registration for intracranial image-guided surgery in the clinical setting. METHODS Thirty-four consecutive patients with different intracranial diseases were scheduled for intracranial image-guided surgery by use of a passive infrared surgical navigation system. Surface registration was performed by use of a Class I laser device that emits a visible laser beam. The Polaris camera system (Northern Digital, Waterloo, ON, Canada) detects the skin reflections of the laser, which the software uses to generate a virtual three-dimensional matrix of the anatomy of each patient. An advanced surface-matching algorithm then matches this virtual three-dimensional matrix to the three-dimensional magnetic resonance therapy data set. Registration error as calculated by the computer was noted. Application accuracy was assessed by use of the localization error for three distant anatomic landmarks. RESULTS Laser surface registration was successful in all patients. For the surgical field, application accuracy was 2.4 ± 1.7 mm (range, 1–9 mm). Application accuracy was higher for the surgical field of frontally located lesions (mean, 1.8 ± 0.8 mm; n = 13) as compared with temporal, parietal, occipital, and infratentorial lesions (mean, 2.8 ± 2.1 mm; n = 21). CONCLUSION Laser scanning for surface registration is an accurate, robust, and easy-to-use method of patient registration for image-guided surgery.
Embedded Brain Machine Interface based on motor imagery paradigm to control prosthetic hand

Brain Machine Interfaces (BMI) have been developed as an alternative way to decode brain signals into control commands and communication devices. A typical BMI uses a computer to process EEG signals; however, current embedded PCs have enough computational resources for fully embedded BMI systems. In this work, the performance of the Odroid-xu4 embedded PC is evaluated as a processing and control device for BMI based on a 2-class motor imagery paradigm. Results show the best accuracy (82.1%) using SVM classifier and minimal processing times (0.11s) on the embedded device, which allows the development of a portable, low cost and trustworthy system.
Immunoglobulin A deficiency in celiac disease in the United States

Multiple European studies report increased prevalence of selective immunoglobulin A deficiency (SIgAD) and partial immunoglobulin A deficiency (PIgAD) in patients with celiac disease (CD). However; prospective data representing North American adults are lacking. While SIgAD precludes the use of IgA‐tissue‐transglutaminase antibody (IgA‐tTG), the effect of PIgAD on IgA‐tTG sensitivity is not well documented. We aim to determine the prevalence and impact of IgA deficiency on CD presentation and diagnosis in North American adult patients.
Improving care near the end of life. Why is it so hard?

A 56-year-old smoker with chronic obstructive pulmonary disease develops pneumonia and respiratory failure and is placed on mechanical ventilation. He dies 2 weeks later, after a stormy intensive care unit (ICU) course complicated by gastrointestinal bleeding and septic shock. The next morning, the ICU team questions how such a series of events occurred. Although each intervention could be justified as a response to a treatable complication, did the team truly consider the patient's overall prognosis or determine whether he really wanted such aggressive care? See also p 1591. The Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatments (SUPPORT) intervention described in this issue ofThe Journalattempted to prevent such high-technology deaths.1The SUPPORT investigators are to be congratulated on a rigorous, complex project. Yet, despite their best efforts in this multicenter randomized clinical trial, the intervention failed to improve any of the study outcomes.
Evaluation of Advanced Control for Li-ion Battery Balancing Systems Using Convex Optimization

Typically, the unique objective pursued in either active or passive balancing is equalization of single cell charge. However, a balancing circuit may offer more control features, like virtual equalization of single cell internal resistance or thermal balancing. Such control features for balancing systems are evaluated in this paper by means of convex optimization. More than one hundred cases in a pure EV application are evaluated. Balancing circuits' efficiency models are implemented and realistic cell-to-cell parameter distributions are considered based on experimental data. Different battery sizes and driving cycles are considered. Balancing circuit topology is taken into account by selecting a specific category of energy transfer: cell-to-heat, bypass, cell-to-pack, pack-to-cell, cell-to-cell shared, cell-to-cell distributed or cell-to-pack-to-cell. In general, better results in terms of energy losses, available capacity or temperature are obtained for the last three categories, even for moderate balancing currents. In particular, remarkable improvements are observed under conditions of high power demand with high variability, i.e., smaller battery sizes and more demanding driving cycles.
Growth Yields of Four Coxiella burnetii Isolates in Four Different Cell Culture Lines

Although Coxiella burnetii is considered to be an obligate intracellular bacterium and grows in embryonated eggs, laboratory animals and cell culture, recently it has been grown in cell-free media and on agar plates. This current study was conducted to compare four cell lines for their yield of C. burnetii. Four different isolates of C. burnetii (Henzerling, Arandale, Cumberland and Timony) were grown in DH82, L929, Vero and XTC-2 cell lines. The DH82 and XTC-2 cells lines produced the highest C. burnetii yield which was slightly less than the yields achieved in recently published studies using cell free media. The Arandale isolate of C. burnetii produced a significantly higher yield in DH82 cells compared to XTC-2 cells (P 0.03).
Purkinje Cell Dendritic Atrophy Induced by Prenatal Stress Is Mitigated by Early Environmental Enrichment

Abstract Background Prenatal stress (PS) in experimental animals causes long-lasting changes in Purkinje cell dendritic morphology. Furthermore, these structural changes are associated with an increase in anxiogenic behaviors in the elevated plus maze (EPM) and open-field (OF) test. Objectives As environmental enrichment (EE) has significant restorative effects on brain neurons and behavior, the aim of this study was to evaluate if postweaning EE mitigates the decrease in Purkinje cell dendritic expansion and exploratory behavior induced by PS in mice. Materials and Methods Restraint stress was induced from gestational day 14 (G14) to G21. Approximately 50% of the PS animals were submitted to the EE paradigm between postnatal days 22 (P22) and P52. At P52 and P82, male animals were behaviorally evaluated, and then the morphology of the cerebellar vermal Purkinje cells was analyzed. Results We found that EE significantly ameliorates the Purkinje cell dendritic atrophy and anxiety-like behavior in the EPM. Conclusion Our data show that long-lasting Purkinje cell dendritic impairments and anxiety-like behavior can be mitigated by postweaning EE.