Miracle-dz/UniFAR-FTUs huggingface dataset:
Randomized trial of 3-hour versus 24-hour infusion of high-dose paclitaxel in patients with metastatic or locally advanced breast cancer: National Surgical Adjuvant Breast and Bowel Project Protocol B-26.

PURPOSE Paclitaxel is an active drug for the treatment of breast cancer; however, the appropriate duration of administration is unknown. We assessed and compared the response rate, event-free survival, survival, and toxicity of paclitaxel 250 mg/m(2) delivered every 3 weeks as a 3-hour or 24-hour infusion. PATIENTS AND METHODS A total of 563 women with stage IV or IIIB breast cancer were randomized into one of two groups: 279 received 3-hour paclitaxel and 284 received 24-hour paclitaxel. Patients were stratified by age, stage of disease, and prior therapy. RESULTS A significantly higher rate of tumor response occurred in the first four cycles of therapy in patients who received the 24-hour infusion of paclitaxel (51% v 41%, respectively; P =.025). Tumor response over all cycles was also significantly higher in the group that received 24-hour infusion (54% v 44%, respectively; P =.023). There were no significant differences in event-free survival or survival between the two arms of the study (P =.9 and.8, respectively). No treatment by stage or by age interactions were observed. During the first four cycles of therapy, at least one episode of >/= grade 3 toxicity (excluding nadir hematologic values, alopecia, and weight change) occurred in 45% of patients who received the 3-hour paclitaxel infusion and in 50% of those who received the 24-hour paclitaxel infusion. Febrile neutropenia, >/= grade 3 infection, and >/= grade 3 stomatitis were less frequent, and severe neurosensory toxicity was more frequent in those who received the 3-hour paclitaxel infusion. Ten treatment-related deaths occurred in the first four cycles. Age, stage, and prior chemotherapy did not influence the effect of treatment. CONCLUSION When administered as a continuous 24-hour infusion, high-dose paclitaxel results in a higher tumor response rate than when administered as a 3-hour infusion but does not significantly improve event-free survival or survival. Paclitaxel as a 24-hour infusion results in increased hematologic toxicity and decreased neurosensory toxicity.
[Clinical Trials for Treatment of Acute Lumbar Sprain by Acupuncture Stimulation of "Yaotong" and Local Ashi-points in Combination with Patients' Lumbar Movement].

OBJECTIVE To observe the clinical effect of acupuncture stimulation of "Yaotong"-point (one acupoint of balance acupuncture therapy) and Ashi-points combined with patients' lumbar movement in the treatment of acute lumbar sprain. METHODS Forty-six acute lumbar sprain patients were randomized into treatment group (26 cases) and control group (20 cases) using a random number table. The patients of the treatment group were treated by acupuncture stimulation of "Yaotong"-point[above Yintang (EX-HN 3)] and local Ashi-points for 20 min, and were asked to move the waist simultaneously during acupuncture stimulation. The treatment was conducted once every other day, 3 times a week, one week in total. Those of the control group were treated by oral administration of loxoprofen sodium tablets (60 mg, twice a day, for one week). The pain severity of lumbago and motor function were assessed by using visual analogue scale(VAS) and present pain intensity(PPI)and lumbar range of motion(ROM) separately. RESULTS Following the treatment, of the 20 and 26 acute lumbar sprain patients in the control and treatment groups, 6(30.0%)and 14(53.8%)were cured, 9 (45.0%) and 11 (42.4%) experienced an improvement in their symptoms, 5 (25.0%) and 1 (3.8%) was invalid, with the effective rates being 75.0% and 96.2%, respectively. Compared with pre-treatment, the ROM and VAS scores were significantly decreased in both the control and treatment groups post-treatment (P<0.01), and the therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate and in the improvement of lumbar motion function and in pain relief (P<0.05,P<0.01). CONCLUSIONS Acupuncture treatment plus patients' lumbar movement is effective in reducing lumbar pain and improving lumbar motor function in the treatment of acute lumbar sprain.
Chronic Urticaria: Etiology and Natural Course in Children

Background: Chronic spontaneous urticaria (CSU) in childhood is infrequent, and information about the disease in children is limited. We attempted to investigate its etiologic factors, natural course, and predictors of prognosis. Methods: All children aged ≤18 years followed for CSU during an 8-year period were analyzed retrospectively, and the final outcomes were queried via a telephone interview. Results: One hundred patients (male/female ratio 1.27) with a median age of 9.2 years (range 0.7–17.2) at symptoms onset were evaluated. The median follow-up was 2.5 years (range 0.2–18.1). An autologous serum skin test was positive in 46.7% of the subjects (n = 45), with a female predominance (71.4%) (p = 0.023). In 13.8% of the children, ANA titers were over 1/100. Food allergy (n = 1), thyroid autoantibodies (n = 3), possible collagen disease (n = 1), and drug usage (deferoxamine) (n = 1) were found to be associated factors. Infections could not be confirmed as the cause of CSU. Recovery was seen in 16.5, 38.8, and 50.0% of the children after 12, 36, and 60 months, respectively. Though in multivariate analysis none of the factors, including age, gender, autologous serum skin test positivity, the presence of angioedema, or other allergic diseases, appeared to predict the prognosis, in univariate analysis being female and being older than 10 years of age predicted an unfavorable prognosis. Conclusion: The etiology of CSU in children is mainly related to an autoreactive background, as in adults. CSU has a favorable prognosis, and resolution is seen in half of the children within 5 years. Girls older than 10 years may have an unfavorable prognosis.
Comparing methods for assessing the effectiveness of subnational REDD+ initiatives

The central role of forests in climate change mitigation, as recognized in the Paris agreement, makes it increasingly important to develop and test methods for monitoring and evaluating the carbon effectiveness of REDD+. Over the last decade, hundreds of subnational REDD+ initiatives have emerged, presenting an opportunity to pilot and compare different approaches to quantifying impacts on carbon emissions. This study (1) develops a Before-After-Control-Intervention (BACI) method to assess the effectiveness of these REDD+ initiatives; (2) compares the results at the meso (initiative) and micro (village) scales; and (3) compares BACI with the simpler Before-After (BA) results. Our study covers 23 subnational REDD+ initiatives in Brazil, Peru, Cameroon, Tanzania, Indonesia and Vietnam. As a proxy for deforestation, we use annual tree cover loss. We aggregate data into two periods (before and after the start of each initiative). Analysis using control areas (‘control-intervention’) suggests better REDD+ performance, although the effect is more pronounced at the micro than at the meso level. Yet, BACI requires more data than BA, and is subject to possible bias in the before period. Selection of proper control areas is vital, but at either scale is not straightforward. Low absolute deforestation numbers and peak years influence both our BA and BACI results. In principle, BACI is superior, with its potential to effectively control for confounding factors. We conclude that the more local the scale of performance assessment, the more relevant is the use of the BACI approach. For various reasons, we find overall minimal impact of REDD+ in reducing deforestation on the ground thus far. Incorporating results from micro and meso level monitoring into national reporting systems is important, since overall REDD+ impact depends on land use decisions on the ground.
The Role of the Audit Committee in Their Oversight of Whistle-Blowing

SUMMARY: We examine the role of the audit committee in their oversight of whistle-blowing. Our study examines whether the quality of the audit committee, captured by its independence, expertise, and diligence, is associated with two whistle-blowing outcomes: the choice of reporting channel (external whistle-blowing versus internal reporting) and the likelihood of retaliation against the whistle-blower. Using a sample of internal and external whistle-blowing cases, we find that a high-quality audit committee reduces the probability that misconduct is reported externally relative to internally, and reduces the probability that a whistle-blower experiences retaliation. We further find that a higher-quality audit committee is associated with the implementation of a stronger internal whistle-blowing system, which in turn reduces the likelihood of external relative to internal reporting. Together, our findings suggest that a high-quality audit committee helps to ensure that whistle-blowing disclosures are recei.
Trapped in the hierarchy: The craft of Dutch city managers

The position of top public managers implies management in three directions: up (political office holders), down (creating organizational capacity), and out (boundary spanning). We know however, little about what these managers do. I present a close-up analysis of city managers using diary analysis, shadowing, and interviews with stakeholders. The analysis interprets their craft as managing up, down, and out. It finds that despite the contemporary emphasis on collaborative public management, the prevalence of boundary spanning activities in top managers’ activity patterns is easily overestimated. Working in the governmental hierarchy consumes most of the managers’ attention.
Implementation constraints in public-private partnership

Purpose This paper aims to empirically investigate the differences and similarities on the implementation constraints in public–private partnership (PPP) in developing and developed economies/countries, represented by Ghana and Hong Kong, respectively. Design/methodology/approach A questionnaire survey was conducted with relevant experienced PPP practitioners in Ghana and Hong Kong. One hundred and three completed questionnaires were received for analysis. Kendall’s coefficient of concordance analysis, mean score ranking, Mann–Whitney U test and quartile grouping were used for data analysis. Findings The results show six implementation constraints with significant differences. Constraints related to the general investment climate of PPP projects (i.e. ecological conditions of PPP) are ranked higher in Ghana than in Hong Kong, whereas constraints related to the organisation and negotiations of PPP projects are higher in Hong Kong than in Ghana. Further, two constraints, lengthy delay in finalising negotiations and lengthy delay due to political debate, are very critical in both jurisdictions, whereas “negative public perceptions on PPP transactions” and “high use of unsolicited proposals” are of less challenge in the implementation of PPP in both jurisdictions. Originality/value The findings of this study contribute to knowledge on the international best practices of PPP. In addition, international private bidders would be informed of the mitigation measures to adopt when engaging in PPP arrangements in any part of the world, whether in a developing or developed economy country.
Factors associated with lipoprotein(a) in chronic kidney disease.

BACKGROUND It is unclear whether lipoprotein(a) (Lp[a]) levels in patients with chronic kidney disease (CKD) are elevated as a result of reduced glomerular filtration rate (GFR) or other factors associated with CKD. The goal of this study is to describe the association of Lp(a) level with GFR in the context of apoprotein(a) (apo[a]) isoform size, race, and other kidney disease-related factors, such as proteinuria, serum albumin level, C-reactive protein (CRP) level, and serum lipid levels. METHODS Lp(a) and apo(a) isoforms were measured in serum samples obtained at baseline from 804 participants in the Modification of Diet in Renal Disease study (GFR range, 13 to 55 mL/min/1.73 m2). The cross-sectional association between Lp(a) level and GFR, apo(a) isoform size, race, and other variables was analyzed in univariate and multivariate linear regression. RESULTS Median Lp(a) level was greater in blacks than whites (97.5 versus 28.1 nmol/L; P < 0.001). Those with a low-molecular-weight apo(a) isoform size had greater Lp(a) levels than those with a high-molecular-weight apo(a) isoform size (57.5 versus 21.3 nmol/L; P < 0.001). Lp(a) level was not associated with GFR. Low-molecular-weight apo(a), black race, and greater levels of proteinuria, CRP, and triglycerides were independently associated with greater Lp(a) levels. CONCLUSION In this population with CKD stages 3 to 4, GFR was not associated with Lp(a) level, whereas other factors related to CKD, such as proteinuria, CRP level, and triglyceride level, as well as genetic factors such as apo(a) isoform size and race, were associated with Lp(a) level.
Handling the Past: Using a Specialized Curriculum to Facilitate Narration of Racial Identities

Identity construction takes place where people spend significant amounts of time. For children, those areas include home and school. Evidence exists that Black children are not given opportunities in school to narrate and affirm their racial identities. Racial identity has been shown to affect school success (Carter, 2008; Lea, 2014; Murrell, 2007), political involvement (Diemer and Li, 2011), and psychological well-being (Seaton, Sellers, & Scottham, 2006). Scholars suggest using history, narration, and dialogue to address this problem; however, current research has yet to incorporate these suggestions. I used a critical action research methodology to explore the influence of a specialized curriculum, document student engagement in critical race discourse, and facilitate the racial identity narrations of fourteen Black fifth-grade students. Targeted digital materials containing affirming Black historical portraits were used as springboards to teacher-facilitated conversations about race and subsequent student written reflections. Qualitative analysis was applied to students’ reflections after viewing and discussing the digital materials, students’ answers to direct questions regarding their racial attitudes, researcher observations, and researcher reflections. The findings suggest that students (1) had a severely limited knowledge of Black history and desired to learn more, (2) further developed affirming Black racial identities despite the historical challenges of Black people and despite personal contemporary problems, (3) were nonjudgmental regarding actions that their Black collective group exhibited regarding agency and subsistence, and (4) held exclusionary attitudes toward White people while suggesting the need for various races and cultures to spend time together. Implications for teachers, teacher educators, policy makers, book publishers, and curriculum developers are discussed. INDEX WORDS: Racial identity, Black consciousness, Emancipatory pedagogy, Black racial identity development, Curriculum, Action research, Insider consciousness HANDLING THE PAST: USING A SPECIALIZED CURRICULUM TO FACILITATE NARRATION OF RACIAL IDENTITIES by ANDREA DENISE KIEL
Plasmodium falciparum Adhesins Play an Essential Role in Signalling and Activation of Invasion into Human Erythrocytes

The most severe form of malaria in humans is caused by the protozoan parasite Plasmodium falciparum. The invasive form of malaria parasites is termed a merozoite and it employs an array of parasite proteins that bind to the host cell to mediate invasion. In Plasmodium falciparum, the erythrocyte binding-like (EBL) and reticulocyte binding-like (Rh) protein families are responsible for binding to specific erythrocyte receptors for invasion and mediating signalling events that initiate active entry of the malaria parasite. Here we have addressed the role of the cytoplasmic tails of these proteins in activating merozoite invasion after receptor engagement. We show that the cytoplasmic domains of these type 1 membrane proteins are phosphorylated in vitro. Depletion of PfCK2, a kinase implicated to phosphorylate these cytoplasmic tails, blocks P. falciparum invasion of red blood cells. We identify the crucial residues within the PfRh4 cytoplasmic domain that are required for successful parasite invasion. Live cell imaging of merozoites from these transgenic mutants show they attach but do not penetrate erythrocytes implying the PfRh4 cytoplasmic tail conveys signals important for the successful completion of the invasion process.
The 'Discouraged Worker Effect' in Public Works Programs: Evidence from the MGNREGA in India

This study investigates the consequences of poor implementation in public workfare programs, focusing on the Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) in India. Using nationally representative data, we test empirically for a discouraged worker effect arising from either of two mechanisms: administrative rationing of jobs among those who seek work and delays in wage payments. We find strong evidence at the household and district levels that administrative rationing discourages subsequent demand for work. Delayed wage payments seem to matter significantly during rainfall shocks. We find further that rationing is strongly associated with indicators of implementation ability such as staff capacity. Politics appears to play only a limited role. The findings suggest that assessments of the relevance of public programs over their lifecycle need to factor in implementation quality.
Investment Opportunities and the Sources of Lifetime Inequality

How much of the dispersion in lifetime earnings, wealth, consumption, and utility is resolved early in life (prior to working life) vs. later? This critical question has received much attention, with influential contributions coming from [keane1997], [storesletten2005], and [huggett2011]. The goal of this paper is to provide quantitative measures of how the full range of households' investment opportunities matters for the fraction of lifetime inequality determined relatively early in life relative to later on. We focus on the role played by three investment opportunities: risky, lumpy college education; risky equity; and costly borrowing. To our knowledge, our work is the first to provide quantitative measures of the importance of each in the temporal resolution of lifetime inequality and the importance of the interaction between them. We find, first, that nearly all income inequality is attributable to human capital variation at age 23. For individuals who have likely completed major educational investments, our results suggest that financial opportunities play only a minor role in altering inequality. Second, we find that the option to invest in high-return, high-risk assets meaningfully increases the importance of initial inequality, whereas the ability to borrow lowers it.
Effects of Dimepramine Fumarate on Physiological and Cognitive Behaviors of Parkinson Patients

Nine patients 55 to 74 years old with Parkinson's disease were tested before and after treatment with 50 to 225 mg dimepramine fumarate (CIBA G-31406) for about three weeks daily in order to determine the drug's effects on electrodermal responsiveness to a series of unpredictably occurring loud sounds. Twelve control subjects were tested and retested with the same procedure. In addition, the Parkinson patients received a number of cognitive tests before and after drug treatment. Results indicated that the drug tends to decrease autonomic arousal responses as measured by resting conductance levels, number of fluctuations in skin conduction per minute, orienting response, and habituation rate. These decreases in measures of arousal generally were accompanied by lowered performance scores on several tests of memory and temporal discrimination ability.
Efficacy and safety of mirodenafil for patients with erectile dysfunction: a meta-analysis of three multicenter, randomized, double-blind, placebo-controlled clinical trials

Abstract Aim: To systematically review evidence on the efficacy and safety of mirodenafil treatment in erectile dysfunction (ED) from randomised controlled trials. Methods: We searched PubMed, Embase and the Cochrane Library database up to March 2013. Two authors independently assessed study quality and extracted data. All data were analyzed using RevMan 5.0. Outcome measures assessed were the International Index of Erectile Function (IIEF), erectile function domain (EFD) score (primary), the Sexual Encounter Profile questions 2 and 3, and the response to the Global Assessment Questionnaire and adverse effects (secondary). Results: A total of 374 participants from three randomized controlled trials were identified in this meta-analysis. After 12 weeks treatment, mirodenafil was found to be more effective than placebo, and tolerability was good. The pooled results showed that the IIEF EFD score for 100 mg mirodenafil group was higher than placebo group (MD = 8.13, 95%CI: 6.64–9.61, p < 0.00001) and the mirodenafil group was also higher than placebo group in the changes from baseline for the IIEF EFD score (MD = 7.32, 95%CI: 5.56–9.07, p < 0.00001), respectively. The most common drug-related adverse events were flushing and headache (mirodenafil versus placebo: 15.8% versus 3.2%, 3.1% versus 0%; respectively). Conclusion: This meta-analysis suggested that mirodenafil is effective and well-tolerated therapy for ED.
Effects of Omega-3 Polyunsaturated Fatty Acids on Platelet Function in Healthy Subjects and Subjects with Cardiovascular Disease

Abstract Hyperactivation and aggregation of platelets play a major role in thrombosis and hemostasis. The aims of this study were to investigate the effects of omega-3 polyunsaturated fatty acids (PUFAs) on platelet function. Light transmission aggregometry and flow cytometric analyses of platelet activation and platelet–leukocyte aggregates were determined at baseline and after 4 weeks of omega-3 (docosahexaenoic acid 520 mg and eicosapentaenoic acid 120 mg) supplementation. In total, 40 healthy subjects and 16 patients with a history of cardiovascular disease (CVD) completed the study. In healthy subjects, omega-3 PUFA significantly reduced adenosine diphosphate (ADP)–induced (maximum amplitude, 77.0% ± 3.2% vs. 71.6% ± 3.4%, p = 0.036; maximum slope, 86.3 ± 1.8 vs. 80.7 ± 2.1, p = 0.014) and adrenaline-induced platelet aggregation (maximum slope, 42.8 ± 2.7 vs. 37.4 ± 3.0, p = 0.013; lag time, 00:21 ± 00:02 vs. 00:31 ± 00:03 s, p = 0.002). Omega-3 PUFA also reduced P-selectin expression (40.5% ± 2.9% vs. 34.4% ± 2.4%, p = 0.049) on platelets and platelet–monocyte aggregates (38.5% ± 2.6% vs. 31.4% ± 2.5%, p = 0.022) after activation with ADP 0.5 µM. There were fewer changes in platelet aggregation and activation found in subjects with CVD. Nevertheless, there was a reduction in the slope of arachidonic acid–induced platelet aggregation (13.21 ± 6.41 vs. 4.88 ± 3.01, p = 0.009) and increased lag time for U46619 (00:16 ± 00:00 vs. 00:29 ± 00:07 s, p = 0.018) induced platelet aggregation. Thus, 4-week supplementation of 640 mg omega-3 PUFA reduced measures of platelet aggregation and activation in healthy subjects but effects were less evident in patients with existing CVD. Our findings support the recommendation that the omega-3 PUFA dose be higher in CVD than among healthy subjects.