Miracle-dz/UniFAR-FTUs huggingface dataset:
PD-L1 Expression in De Novo Metastatic Castration-sensitive Prostate Cancer

De novo metastatic castration-sensitive prostate cancer (mCSPC) is small subgroup of prostate cancer associated with poor prognosis. The aim of our study was to assess the expression of programmed death-ligand 1 (PD-L1) in tumor cells of de novo mCSPC patients. Patients referred to our institution from January 2007 to October 2017 with de novo mCSPC and available diagnostic tissue were included. We tested the PD-L1 pharmaDx qualitative immunohistochemical assay, a monoclonal rabbit anti-PD-L1, clone 28-8 intended for use in the detection of PD-L1 protein in formalin-fixed paraffin-embedded. Kaplan-Meier method was used to estimate survivals according to the expression of PD-L1. The study population included 32 de novo mCSPC patients, analyzed for PD-L1 expression using 2 cut-off values (1% and 5%) to define the positivity. Total of 46.9% of cases had tumor PD-L1 expression ≥1%, and 31.3% had expression ≥5%. No differences were found between the PD-L1 expression ≥1% and the involvement of liver, lung, and number of bone metastases, and the disease volume based on CHAARTED classification. PD-L1− tumors had higher incidence of Gleason score ≥8 compared with PD-L1+ tumors (P=0.037), while the incidence of lymph node metastases was higher in PD-L1+ tumors (P=0.044). No difference in the median overall survival (mOS) was observed between the PD-L1− population and the PD-L1+ patients (43.8 vs. 29.6 mo; P=0.88). The tumor PD-L1 expression cannot be considered a prognostic factor for de novo mCSPC, even if its prognostic and predictive significance have to be thoroughly investigated to better define the selected group of prostate cancer patients that might benefit from checkpoint blockade immunotherapy.
Quantifying the transmission dynamics of MRSA in the community and healthcare settings in a low-prevalence country

Significance Methicillin-resistant Staphylococcus aureus (MRSA), traditionally associated with hospitals, is increasingly circulating in the community. This imposes, in turn, a potential burden on hospital infection control due to a more frequent hospitalization of colonized patients. We developed an individual-based model, reproducing community and healthcare settings, to understand the epidemiological drivers of MRSA and the connections between the society and the healthcare institutions. We show that in Norway, a low-prevalence country, the rise of infections is driven by an increasing inflow of cases from abroad rather than by an ongoing epidemic. We demonstrate the major role played by households in transmitting MRSA and show that the burden on hospitals from the growing community circulation is still limited thanks to aggressive infection-control protocols. Methicillin-resistant Staphylococcus aureus (MRSA) is a primarily nosocomial pathogen that, in recent years, has increasingly spread to the general population. The rising prevalence of MRSA in the community implies more frequent introductions in healthcare settings that could jeopardize the effectiveness of infection-control procedures. To investigate the epidemiological dynamics of MRSA in a low-prevalence country, we developed an individual-based model (IBM) reproducing the population’s sociodemography, explicitly representing households, hospitals, and nursing homes. The model was calibrated to surveillance data from the Norwegian national registry (2008–2015) and to published household prevalence data. We estimated an effective reproductive number of 0.68 (95% CI 0.47–0.90), suggesting that the observed rise in MRSA infections is not due to an ongoing epidemic but driven by more frequent acquisitions abroad. As a result of MRSA importations, an almost twofold increase in the prevalence of carriage was estimated over the study period, in 2015 reaching a value of 0.37% (0.25–0.54%) in the community and 1.11% (0.79–1.59%) in hospitalized patients. Household transmission accounted for half of new MRSA acquisitions, indicating this setting as a potential target for preventive strategies. However, nosocomial acquisition was still the primary source of symptomatic disease, which reinforces the importance of hospital-based transmission control. Although our results indicate little reason for concern about MRSA transmission in low-prevalence settings in the immediate future, the increases in importation and global circulation highlight the need for coordinated initiatives to reduce the spread of antibiotic resistance worldwide.
Volume growth trend and correlation of atrial diameter with lateral ventricular volume in normal fetus and fetus with ventriculomegaly

Abstract To explore the growth trend of fetal lateral ventricular volume, for understanding the relationship between atrial diameter (AD) and volume in normal fetus and fetus with ventriculomegaly. Overall, 97 sequential fetal head magnetic resonance imaging scans were performed; these pertained to 50 fetuses with normal lateral ventricles [normal group; gestational age (GA): 24–38 weeks] and 47 fetuses with ventriculomegaly (VM) (VM group; GA: 24–37 weeks). The left, right, and total lateral ventricular volume were measured using 3-dimensional magnetic resonance hydrography (MRH). Correlation coefficient (r) was calculated to assess the relationships of measurements. Lineal regression analysis was used to assess correlation of AD and GA with volume. Between-group differences in terms of AD and volume were assessed using t test. Significant linear growth was observed in the total lateral ventricular volume compared with GA in the normal group with a relative growth rate of 2.87% per week (P <.001). Significant linear relationship between AD and volume was observed, and a significant equation was acquired in the normal group and VM groups, respectively, using the simple linear regression model: left volume = 0.438 ∗ normal left diameter (NLD) + 1.359; right volume = 0.493 ∗ normal right diameter (NRD) + 1.012; left volume = 0.959 ∗ left diameter in VM (VLD) − 2.074; right volume = 0.799 ∗ right diameter in VM (VRD) − 0.443. A significant equation was obtained in the normal group and the VM group, using the multiple linear regression model: Total volume (mL) = 0.396 ∗ NLD + 0.410 ∗ NRD + 3.101; and total volume = 0.989 ∗ VLD + 0.834 ∗ VRD − 3.141, respectively. In terms of AD and volume, the left lateral ventricle was significantly larger than the right side in both groups. The volume of lateral ventricle in AD ≥10 mm group was larger than that in the AD <10 mm group. The total volume in the VM group was significantly larger than that in the normal group. The total lateral ventricular volume increased with GA. AD can be used to evaluate the fetal ventricular volume.
Situation Awareness and the Decision-making Processes of Final Year Nursing Students.

AIMS AND OBJECTIVES To investigate final year nursing students' use of situation awareness (SA) when making clinical decisions about patients' progress post-surgery. BACKGROUND Making clinical decisions about patient care is a generic nursing competence, developed in pre-registration nursing programs and critical to providing safe patient care. SA is an important precursor to making decisions and is linked to improved clinical outcomes. However there is evidence to suggest that nursing students feel inadequately prepared to make clinical decisions. DESIGN Endsley's (2000) 3-level situation awareness framework was used to guide the study. Level 1 SA is perception of information required to make a decision. Level 2 relates to comprehending the information. Level 3 SA is projecting how this information will inform the future. Twelve final year nursing students were recruited to participate. Think aloud research method was used to capture students' decision-making, followed by semi-structured interviews. Data was analysed using an adapted protocol analysis and was encoded inductively. The COREQ checklist has been used in reporting the study. RESULTS Students demonstrated levels 1, 2 and 3 SA when making clinical decisions. However, it was not demonstrated consistently and at times subsequent decision-making was inappropriate. Three themes emerged: 'systems approach to assessment of post-operative patients'; 'policy drives practice'; and 'deferring decisions to registered nurses'. Within the themes students demonstrated differing levels of SA. CONCLUSION Making safe clinical decisions is a paramount skill for nurses however student nurses are ill equipped to undertake this skill. SA is important in informing safe decision-making but students' use of SA is variable. Cognitive apprenticeship, applied to supporting development of SA, affords the opportunity to develop students' decision-making. RELEVANCE TO CLINICAL PRACTICE Clinical decision-making is a generic competence for all registered nurses and imperative for safe practice. However, student nurses are unprepared to undertake this skill once registered. This article is protected by copyright. All rights reserved.
A structural equation modeling approach for the association of a healthy eating index with metabolic syndrome and cardio-metabolic risk factors among obese individuals

We introduce a novel and simple method for assessing audiences’ emotional responses to audiovisuals (e.g. films). Viewers watched movies and TV commercials from different genres while wearing PPG (photoplethysmography) optic sensors on their wrists. Heart rate variability (HRV) synchrony was observed among the audience. Based on this between-subject synchrony measure, we identified emotionally arousing segments from the materials. New participants were then invited to watch these identified segments along with some randomly selected segments as control; they reported that the former was more engaging. This finding was confirmed in an online study with a larger cohort. While some specific effects varied depending on movie genre or gender, HRV-based editing generally performed better than the control. These findings suggest that HRV synchrony can be used as a new tool for audience psychology, and potentially also for automatically creating short trailers out of movies in a principled manner while taking into account the human perspective.
Effect of Nocturnal Hypoxia on Nocturia in Patients With Obstructive Sleep Apnea

Purpose To identify the association between nocturia and obstructive sleep apnea (OSA), we compared results of polysomnography (PSG) with the presence or absence of nocturia in patients with suspected OSA. Methods Patients underwent PSG for suspected OSA. The International Prostate Symptom Score and quality of life (IPSS/QoL) questionnaire was evaluated to assess voiding symptoms that may affect sleep quality. The results of PSG were compared between patient groups with or without nocturia. Results In logistic regression analysis, age (odds ratio [OR], 1.052; P=0.004), diabetes mellitus (OR, 6.675; P<0.001), mean O2 saturation (OR, 0.650; P=0.017), oxygen desaturation index (ODI) 3 (OR, 1.193; P=0.010), and ODI4 (OR, 1.136; P=0.014) affected nocturia independently among the OSA-suspected patients. Conclusions Hypoxia caused by OSA affects the incidence of nocturia. Less desaturated OSA patients with nocturia may require more urological evaluation and treatment for nocturia even after the correction of OSA.
Effects of workaholism on volunteer firefighters’ performance: a moderated mediation model including supervisor recognition and emotional exhaustion

ABSTRACT Background and Objectives: Although workaholism has been associated with job performance, the mechanisms that explain this relationship remain unclear. In this study, we investigated the conditional indirect effects of workaholism on performance via emotional exhaustion, across low and high levels of supervisor recognition. Methods: We conducted an empirical cross-sectional study using a sample of 1028 volunteer firefighters who completed a self-report questionnaire assessing workaholism, emotional exhaustion, work performance, and supervisor recognition. Results: Tests of latent interactions were performed using the latent moderated structural equation modeling approach. Consistent with our predictions, results revealed that the negative indirect effects of workaholism on performance, through emotional exhaustion, were stronger when supervisor recognition was low. Conclusions: Theorical contributions and perspectives, as well as implications for practice are discussed.
Ddx4+ Oogonial Stem Cells in Postmenopausal Women’s Ovaries: A Controversial, Undefined Role

Recent studies support the existence of oogonial stem cells (OSCs) in the ovarian cortex of different mammals, including women.These cells are characterized by small size, membrane expression of DEAD(Asp-Glu-Ala-Asp)-box polypeptide-4 (Ddx4), and stemness properties (such as self-renewal and clonal expansion) as well as the ability to differentiate in vitro into oocyte-like cells. However, the discovery of OSCs contrasts with the popular theory that there is a numerically defined oocyte pool for female fertility which undergoes exhaustion with menopause. Indeed, in the ovarian cortex of postmenopausal women OSCs have been detected that possess both viability and capability to differentiate into oocytes, which is similar to those observed in younger patients. The pathophysiological role of this cell population in aged women is still debated since OSCs, under appropriate stimuli, differentiate into somatic cells, and the occurrence of Ddx4+ cells in ovarian tumor samples also suggests their potential involvement in carcinogenesis. Although further investigation into these observations is needed to clarify OSC function in ovary physiology, clinical investigators and researchers studying female infertility are presently focusing on OSCs as a novel opportunity to restore ovarian reserve in both young women undergoing early ovarian failure and cancer survivors experiencing iatrogenic menopause.
Wnt-11 as a Potential Prognostic Biomarker and Therapeutic Target in Colorectal Cancer

The expression of the secreted factor Wnt-11 is elevated in several types of cancer, including colorectal cancer, where it promotes cancer cell migration and invasion. Analysis of colorectal cancer gene expression databases associated WNT11 mRNA expression with increased likelihood of metastasis in a subset of patients. WNT11 expression was correlated with the expression of the Wnt receptors FZD6, RYK, and PTK7, and the combined expression of WNT11, FZD6 and RYK or PTK7 was associated with an increased risk of 5-year mortality rates. Immunohistochemical analysis of Wnt-11 in a cohort of 357 colorectal cancer patients found significantly higher Wnt-11 levels in tumors, compared with benign tissue. Elevated Wnt-11 levels occurred more frequently in rectal tumors than in colonic tumors and in tumors from women than men. In univariate analysis, increased Wnt-11 expression was also associated with tumor invasion and increased 5-year mortality. High Wnt-11 levels were not associated with high levels of nuclear β-catenin, suggesting Wnt-11 is not simply an indicator for activation of β-catenin-dependent signaling. Expression of Wnt-11 in colorectal cancer cell lines expressing low endogenous Wnt-11 inhibited β-catenin/Tcf activity and increased ATF2-dependent transcriptional activity. WNT11 gene silencing and antibody-mediated inhibition of Wnt-11 in colorectal cancer cell lines expressing high Wnt-11 reduced their capacity for invasion. Together, these observations suggest that Wnt-11 could be a potential target for the treatment of patients with invasive colorectal cancer.
Synthesis and Characterization of Chitosan/Reduced Graphene Oxide Hybrid Composites

Graphene family materials (GFM) are currently considered to be one of the most interesting nanomaterials with a wide range of application. They can also be used as modifiers of polymer matrices to develop composite materials with favorable properties. In this study, hybrid nanocomposites based on chitosan (CS) and reduced graphene oxide (rGO) were fabricated for potential use in bone tissue engineering. CS/rGO hydrogels were prepared by simultaneous reduction and composite formation in acetic acid or lactic acid and crosslinked with a natural agent—tannic acid (TAc). A broad spectrum of research methods was applied in order to thoroughly characterize both the components and the composite systems, i.e., X-ray Photoelectron Spectroscopy, X-ray Diffractometry, Attenuated Total Reflection Fourier-Transform Infrared Spectroscopy, Scanning Electron Microscopy, ninhydrin assay, mechanical testing, in vitro degradation and bioactivity study, wettability, and, finally, cytocompatibility. The composites formed through the self-assembly of CS chains and exfoliated rGO sheets. Obtained results allowed also to conclude that the type of solvent used impacts the polymer structure and its ability to interact with rGO sheets and the mechanical properties of the composites. Both rGO and TAc acted as crosslinkers of the polymer chains. This study shows that the developed materials demonstrate the potential for use in bone tissue engineering. The next step should be their detailed biological examinations.
Clinical Response of Live-Attenuated, Listeria monocytogenes Expressing Mesothelin (CRS-207) with Chemotherapy in Patients with Malignant Pleural Mesothelioma

Purpose: Malignant pleural mesothelioma (MPM) is an aggressive cancer associated with poor prognosis. CRS-207 is a live-attenuated Listeria monocytogenes engineered to express mesothelin, a tumor-associated antigen highly expressed in MPM. CRS-207 induces antitumor immune responses and increases susceptibility of neoplastic cells to immune-mediated killing. Patients and Methods: Patients with unresectable MPM, ECOG 0 or 1, and adequate organ and pulmonary function were enrolled in this multicenter, open-label phase Ib study. They received two priming infusions of 1 × 109 CFU CRS-207, followed by pemetrexed/cisplatin chemotherapy, and CRS-207 booster infusions. Primary objectives were safety and induction of immune response. Secondary/exploratory objectives included tumor response, progression-free survival (PFS), overall survival (OS), immune subset analysis, and gene-expression profiling of tumor. Results: Of 35 evaluable patients, 89% (31/35) had disease control with one complete response (3%), 19 partial responses (54%), and 10 stable disease (29%). The estimated median duration of response was 5.0 months (95% CI, 3.9–11.5). The median PFS and OS were 7.5 (95% CI, 7.0–9.9) and 14.7 (95% CI, 11.2–21.9) months, respectively. Tumor size reduction was observed post–CRS-207 infusion prior to chemotherapy in 11 of 35 (31%) patients. No unexpected treatment-related serious adverse events or deaths were observed. IHC analysis of pre- and post–CRS-207 treatment tumor biopsies revealed possible reinvigoration and proliferation of T cells, increased infiltration of dendritic and natural killer cells, increased CD8:Treg ratio, and a shift from immunosuppressive M2-like to proinflammatory M1-like macrophages following CRS-207 administration. Conclusions: Combination of CRS-207 and chemotherapy induced significant changes in the local tumor microenvironment and objective tumor responses in a majority of treated patients.
Anti-Apoptotic Effects of Docosahexaenoic Acid in IL-1β-Induced Human Chondrosarcoma Cell Death through Involvement of the MAPK Signaling Pathway

Osteoarthritis (OA) is a degenerative disease characterized by progressive articular cartilage destruction and joint marginal osteophyte formation with different degrees of synovitis. Docosahexaenoic acid (DHA) is an unsaturated fatty acid with anti-inflammatory, antioxidant, and antiapoptotic functions. In this study, the human chondrosarcoma cell line SW1353 was cultured in vitro, and an OA cell model was constructed with inflammatory factor IL-1β stimulation. After cells were treated with DHA, cell apoptosis was measured. Western blot assay was used to detect protein expression of apoptosis-related factors (Bax, Bcl-2, and cleaved caspase-3) and mitogen-activated protein kinase (MAPK) signaling pathway family members, including extracellular signal-regulated kinase (ERK), c-JUN N-terminal kinase (JNK), and p38 MAPK. Our results show that IL-1β promotes the apoptosis of SW1353 cells, increases the expression of Bax and cleaved caspase-3, and activates the MAPK signaling pathway. In contrast, DHA inhibits the expression of IL-1β, inhibits IL-1β-induced cell apoptosis, and has a certain inhibitory effect on the activation of the MAPK signaling pathway. When the MAPK signaling pathway is inhibited by its inhibitors, the effects of DHA on SW1353 cells are weakened. Thus, DHA enhances the apoptosis of SW1353 cells through the MAPK signaling pathway.
TECLA—an innovative technical approach for prostate cancer registries

Abstract Objective: To present a code-driven, electronic database for patients TrEated with robotic-assisted radiCaL prostAtectomy (TECLA), developed at Innlandet Hospital (IH), Trust, Norway, for research, local quality control and to deliver data to the National Cancer Registry of Norway (CRN). Clinical data are directly extracted from the structured documentation in the electronic medical record (EMR). Materials and methods: The urological department at IH treats about 200 patients with robotic-assisted radical prostatectomy (RARP) annually. All consenting patients registered with the procedure code for RARP are included in TECLA. Clinical data are obtained automatically from the EMR, by structured forms. Patient-reported outcome and experience measures (PROMs and PREMs) are filled in by the patients on an iPad or a smartphone. Results: The basic construct of TECLA is presented. From August 2017 to June 2018, 200 men were treated with RARP, of which 182 (91%) provided consent for inclusion in the register. Of these, 97% completed the PROM survey before treatment and 91% at 3 months follow-up. PREMs were completed by 78%. All clinical variables for the hospital stay and for the 6-week follow-up were more than 95% complete. Conclusion: This entirely electronic surgical quality register is easy to use, both for patients and clinicians, and has a high capture rate. The data collection is linked to the clinicians’ workflow, without double data entry, so entering data does not add any extra work. The register design can be used by other hospitals for various surgical procedures.