Miracle-dz/UniFAR-FTUs huggingface dataset:
Differential Changes in Muscle Composition Exist in Traumatic and Nontraumatic Neck Pain

Study Design. A population based cross-sectional study. Objective. To clarify relative constituents of viable muscle in 2-dimensional cross-sectional area (CSA) measures of ventral and dorsal cervical muscles in patients with chronic whiplash-associated disorders (WAD), idiopathic neck pain, and healthy controls. Summary of Background Data. Previous data using T1-weighted magnetic resonance image demonstrated large amounts of neck muscle fat infiltration and increased neck muscle CSA in patients with chronic WAD but not in idiopathic neck pain or healthy controls. Methods. Magnetic resonance images were obtained for 14 cervical muscle regions in 136 females, including 79 with chronic whiplash, 23 with chronic idiopathic neck pain, and 34 healthy controls. Results. Without fat removed, relative CSA of 7 of 14 muscle regions in the participants with chronic WAD was larger, 3 of 14 smaller and 4 of 14 similar to healthy individuals. When T1-weighted signal representing the lipid content of these muscles was removed, 8 of 14 relative muscle CSA in patients with whiplash were similar, 5 of 14 were smaller and only 1 of 14 was larger than those observed in healthy controls. Removal of fat from the relative CSA measurement did not alter findings between participants with idiopathic neck pain and healthy controls. Conclusion. These findings clarify that previous reports of increased relative CSA in patients with chronic whiplash represent cervical muscle pseudohypertrophy. Relative muscle CSA measures reveal atrophy in several muscles in both patients with WAD and idiopathic neck pain, which supports inclusion of muscle conditioning in the total management of these patients. Level of Evidence: 3
Amplification of PRKCI, located in 3q26, is associated with lymph node metastasis in esophageal squamous cell carcinoma

DNA amplification is one of the mechanisms to activate genes that are implicated in neoplastic transformation and gain of chromosome band 3q26 is a common event in squamous cell carcinomas. The aim of the present work was to identify the specific target gene from four candidates (MDS1, PRKCI, ECT2, and PIK3CA) located on 3q26 amplification in esophageal squamous cell carcinomas (ESCCs). To assess the prevalence of copy number gains of putative genes, fluorescence in situ hybridization (FISH) was applied on 108 ESCCs and 9 ESCC cell lines. Our data showed that MDS1 and PRKCI were more frequently gained. Positive correlation was found only for PRKCI between amplification and tumor size (P = 0.043), lymph node metastasis (P = 0.015) and clinical stage (P = 0.002). PRKCI gene amplification was highly correlated with protein overexpression (P = 0.009), suggesting that gene amplification is one important mechanism involved in PRKCI overexpression. To investigate further the role of PRKCI alteration in esophageal tumors, a tissue microarray containing samples from 180 ESCCs was used for immunohistochemistry analysis. Statistical analysis revealed that PRKCI overexpression was correlated with lymph node metastasis (P = 0.002) and higher stage (P = 0.004). Performing multivariate logistic regression analysis, a significant association between PRKCI overexpression and presence of lymph node metastasis was found, which was independent of T‐stage of the primary tumors (P = 0.004). Our results indicate that PRKCI is an attractive target in the 3q26 amplicon and that it may serve as a molecular marker for metastasis and occult advanced tumor stages in ESCC. © 2007 Wiley‐Liss, Inc.
Towards a Better Understanding of Anterior Knee Pain Don ́t Forget to Look Up

Anterior knee pain (AKP), referred to as chronic pain perceived in the anterior aspect of the knee following exclusion of other objective causes of pain, is one of the most common and most challenging knee problems to treat. So, in reality it is a diagnosis of exclusion. It affects physically active individuals between the ages of 15 and 30, females being more likely to develop it. These patients often also tend to report instability of the knee that typically occurs going up or down stairs or on an incline. Besides pain and giving way, these patients also show a different amount of chronic disability, some of them are severely impaired, while others only have a slight disability. AKP is typically caused and aggravated by ascending or descending stairs, squatting, kneeling, using high-heeled shoes and sitting with flexed knees for prolonged periods of time (“movie sign”). Therefore, it is likely that AKP patients are prone to develop avoiding behaviours that may worsen their disability. It causes limitation from participation in sports, sick leave, and generally a reduced quality of life.
The Effect of Total Sleep Deprivation on Cognitive Functions in Normal Adult Male Subjects

This study was conducted to evaluate the effect of acute sleep deprivation on cognitive functions. A total of 18 healthy right handed males were deprived of sleep for 24 hours. Luria-Nebraska Neuropsychological Battery and calculation & digit-span subtest of K-WAIS were administered before and after sleep deprivation in order to examine the changes of cognitive functions. There were no differences in freedom from distractibility, tacile function, visual function, reading, writing, arithmetic and intellectual process function. However, the cognitive functions such as motor, rhythm, receptive & expressive speech, memory and complex verbal arithmetic function were decreased after sleep deprivation. All of these functions are known to be related to the right anterior hemisphere. For localization scales, the scores of right frontal and right temporal dysfunction scale were increased after sleep deprivation. These results indicate that sleep deprivation has a negative effect on cognitive functions, especially those associated with right anterior hemisphere or subcortical areas.
Enhancing performance in health care: a theoretical perspective on agency and the role of information.

This paper examines the role of information in securing control of health care systems. The discussion focuses on the impact of the proposed 'Performance Framework', which entails a significant increase in the importance attached to formal performance indicators in the management of the UK National Health Service. The paper starts with a discussion of the role of performance data in securing organizational control within health care systems and summarizes recent research into the behavioural consequences of seeking to control health care agents using such information. A theoretical principal/agent model is then used to illustrate the incentives that exist for dysfunctional behaviour within health care when only imperfect information systems are available. The theoretical results are then examined in the context of a qualitative empirical study, which elicited the perceptions of managers and health care professionals connected with eight NHS hospitals. The study confirmed the existence and importance of serious dysfunctional consequences arising from the use of information as a means of control, and concludes that the Performance Framework will be successful only if it is used in careful conjunction with other means of control.
Application of immunohistochemistry to the diagnosis of malignant mesothelioma.

CONTEXT The diagnosis of malignant mesothelioma (MM) is rendered with the aid of immunohistochemistry to demonstrate the presence of "mesothelial," "epithelial," or "sarcomatous" differentiation. Antibody panels that have been proposed for the distinction between MM and other neoplasms usually include 2 or more epithelial markers used to exclude the diagnosis of a carcinoma, such as monoclonal and polyclonal carcinoembryonic antigen, Ber-EP4, B72.3, CD15, MOC-31, thyroid transcription factor 1, BG8, and others, and 2 or more mesothelial markers used to confirm the diagnosis of MM, such as cytokeratin 5/6, calretinin, HBME-1, thrombomodulin, WT-1, mesothelin, D2-40, and podoplanin. In general, most antibody panels provide excellent sensitivity and specificity for the differential diagnosis between MM epithelial variant and adenocarcinoma, particularly of lung origin. However, the accuracy of these markers is lower for the diagnosis of sarcomatous MM and for the differential diagnosis between MM and squamous cell carcinoma and carcinomas of renal, ovarian, and other origin. OBJECTIVE To identify optimal antibody panels for the diagnosis of MM. DATA SOURCES Literature review to determine how many and which mesothelial and epithelial markers need to be included in differential diagnosis antibody panels. CONCLUSIONS Various antibody panels have been recommended for the diagnosis of MM, with no overall consensus about how many and which markers should be used. A recent study with Bayesian statistics has demonstrated that the use of many markers does not provide higher diagnostic accuracy than the use of selected single antibodies or various combinations of only 2 markers. There is a need for the development of evidence-based or consensus-based guidelines for the diagnosis of MM in different differential diagnosis situations.
Gender differences in the extent and timing of the reflected arterial waveform in the presence of coronary artery disease

Background: The non-invasive assessment of arterial dysfunction may improve cardiovascular (CV) risk assessment. We studied the relationship of the reflected wave transit time (RWT) and augmentation index (AIX), both derived from pulse wave analysis (PWA), in the presence/absence of coronary artery disease (CAD), and compared PWA with the ankle-brachial index (ABI). Methods: A trained research nurse measured PWA (radial applanation tonometry, SphygmoCor device) and ABI (hand-held Doppler) in a consecutive series of fasted patients resting supine prior to elective coronary angiography. Measurements were undertaken blind to other clinical information. Mean differences in RWT, AIX, and ABI in the presence of CAD were adjusted for age, height, mean BP, fasting cholesterol, ever smoked, and treated hypertension using multiple linear regression. Results: We recruited 125 patients (49 women) with a mean age of 65 years, total cholesterol 4.4 mmol/l, BP 136/78, current smokers 22%, and previous myocardial infraction 30%. A statistically significant interaction between sex and CAD was present for both RWT (p = 0.003) and AIX (p = 0.03). No interaction was demonstrated for ABI (p = 0.21). Mean differences for men and women in the presence/absence of CAD were: RWT −10.1 vs. +5.2 milliseconds; AIX +1.2 vs. −5.4; ABI −0.02 vs. −0.10. Male and female area under receiver operating characteristic curves for CAD detection differed for RWT (0.33 vs. 0.67) and AIX (0.62 vs. 0.36), but were similar for ABI (0.40 vs. 0.34). Conclusion: The timing and extent of arterial wave reflections in the presence of CAD may differ in men and women.
Corneal Cell Morphology in Keratoconus: A Confocal Microscopic Observation.

PURPOSE To evaluate corneal cell morphology in patients with keratoconus using an in vivo slit scanning confocal microscope. METHODS A cross-sectional study was conducted to evaluate the corneal cell morphology of 47 keratoconus patients and 32 healthy eyes without any ocular disease. New keratoconus patients with different disease severities and without any other ocular co-morbidity were recruited from the ophthalmology department of a public hospital in Malaysia from June 2013 to May 2014. Corneal cell morphology was evaluated using an in vivo slit-scanning confocal microscope. Qualitative and quantitative data were analysed using a grading scale and the Nidek Advanced Visual Information System software, respectively. RESULTS The corneal cell morphology of patients with keratoconus was significantly different from that of healthy eyes except in endothelial cell density (P = 0.072). In the keratoconus group, increased level of stromal haze, alterations such as the elongation of keratocyte nuclei and clustering of cells at the anterior stroma, and dark bands in the posterior stroma were observed with increased severity of the disease. The mean anterior and posterior stromal keratocyte densities and cell areas among the different stages of keratoconus were significantly different (P < 0.001 and P = 0.044, respectively). However, the changes observed in the endothelium were not significantly different (P > 0.05) among the three stages of keratoconus. CONCLUSION Confocal microscopy observation showed significant changes in corneal cell morphology in keratoconic cornea from normal healthy cornea. Analysis also showed significant changes in different severities of keratoconus. Understanding the corneal cell morphology changes in keratoconus may help in the long-term monitoring and management of keratoconus.
Relative dose intensity--improving treatment and outcomes in early-stage breast cancer: a retrospective study.

PURPOSE/OBJECTIVES To determine the amount of chemotherapy delivered compared to amount of chemotherapy scheduled by calculating relative dose intensity (RDI) and to identify factors associated with nonadherence of scheduled treatment regimens for patients with early-stage breast cancer (ESBC). DESIGN Retrospective, descriptive, correlational study. SETTING Two community hospital cancer centers in northern Michigan. SAMPLE 77 patients with ESBC receiving adjuvant chemotherapy. METHODS The RDI Calculator™ was used for data collection. A worksheet was developed for each patient and included characteristics, treatment information, and RDI calculations. SAS®, version 19.2, was used for multivariate analyses based on logistical regression analyzing relationships among dependent and independent variables. MAIN RESEARCH VARIABLES Dependent variables were RDI prescribed and RDI received. Independent variables included chemotherapy regimen, clinical characteristics, planned dose, and schedule. FINDINGS The average RDI was 86.6%. The average RDI was 86.7% for patients younger than age 65, and 85.5% for those 65 and older. The most common reasons for dose reduction or dose delay were treatment toxicity, chronic disease risk factors, age, unplanned versus planned treatment dose, institution (different standards of care), patient preference, and weight. CONCLUSIONS Meeting treatment goals of RDI for patients with ESBC has been shown to increase the disease-free survival rate and positively affects overall survival. IMPLICATIONS FOR NURSING Nurses have the unique opportunity to case manage patients with ESBC throughout the spectrum of care. One of the key areas of focus is education of the patient and her family members from the time of diagnosis throughout treatment and rehabilitation.
Regulatory Function of Trefoil peptides (TFF) on Intestinal Cell Junctional Complexes

Abstract Trefoil peptides (TFF) are constitutively expressed in the gastrointestinal tract and are involved in gastrointestinal defence and repair by promoting epithelial restitution. Although there is a general consensus regarding the pro-motogenic activity of trefoil peptides, the cellular mechanisms through which they mediate these processes are not completely understood. Pertubation of the E-cadherin/catenin complex at intercellular junctions appears to be a functional pathway through which TFF2 and TFF3 promote cell migration. Tight junction complexes seal the paracellular spaces between cells and contribute to epithelial barrier function. TFF3 peptide stimulation stabilises these junctions through upregulation of the tightening protein claudin-1 and redistribution of ZO-1 from the cytoplasm to the intercellular membrane with an increase in binding to occludin. Modulation of the functional activity and subcellular localisation of epithelial junctional adhesion molecules represent important mechanisms by which trefoil peptides may promote migration of intestinal epithelial cells in vitro and healing of mucosal damage in vivo.
Food Recovery Program at Farmers’ Markets Increases Access to Fresh Fruits and Vegetables for Food Insecure Individuals

ABSTRACT Food recovery programs are an increasingly popular method to decrease the amount of food waste in the United States while increasing healthy food access for food insecure individuals. One such program is the Heartside Gleaning Initiative that began in 2014 in Grand Rapids, Michigan. The program partners with low-income volunteers to collect fresh produce from farmers’ markets for redistribution. From June to October 2014, 17,000 pounds of fresh produce was provided to low-income individuals and food pantries. A survey of participants indicated high usage of the produce and high satisfaction with the gleaning program. This program confirms that gleaning is a viable method of reducing barriers to accessing produce for food pantries and food insecure individuals.
HIV voluntary counselling and testing among recently initiated and traditionally circumcised men in the Eastern Cape Province of South Africa

HIV voluntary counselling and testing (VCT) is a cornerstone of the national strategic plan for HIV/AIDS treatment, care and support in South Africa. However, research shows that the utilisation of VCT services is disappointingly low, particular among males. This article focuses on the factors associated with the intention to test for HIV-infection among recently initiated and traditionally circumcised men in the rural areas of Eastern Cape Province, South Africa. Individual face-to-face interviews were conducted among 1656 sexually active men. Logistic regression analyses were used to explore the association between intention to test for HIV and psychosocial factors. Overall, 35.1% of the participants reported ever having tested for HIV. Intention to test for HIV was positively associated with perceived probability of getting an STI, positive attitudes towards gender-based violence, received general teachings about being a responsible man and highest grade passed. These findings provide specific information that can be used in the development of a focused cultural sensitive STI/HIV prevention programme aimed to increase VCT uptake among sexually active young men, which can be integrated into initiation and health education practices.
Citrus polyphenol hesperidin stimulates production of nitric oxide in endothelial cells while improving endothelial function and reducing inflammatory markers in patients with metabolic syndrome.

CONTEXT Hesperidin, a citrus flavonoid, and its metabolite hesperetin may have vascular actions relevant to their health benefits. Molecular and physiological mechanisms of hesperetin actions are unknown. OBJECTIVE We tested whether hesperetin stimulates production of nitric oxide (NO) from vascular endothelium and evaluated endothelial function in subjects with metabolic syndrome on oral hesperidin therapy. DESIGN, SETTING, AND INTERVENTIONS: Cellular mechanisms of action of hesperetin were evaluated in bovine aortic endothelial cells (BAEC) in primary culture. A randomized, placebo-controlled, double-blind, crossover trial examined whether oral hesperidin administration (500 mg once daily for 3 wk) improves endothelial function in individuals with metabolic syndrome (n = 24). MAIN OUTCOME MEASURE We measured the difference in brachial artery flow-mediated dilation between placebo and hesperidin treatment periods. RESULTS Treatment of BAEC with hesperetin acutely stimulated phosphorylation of Src, Akt, AMP kinase, and endothelial NO synthase to produce NO; this required generation of H(2)O(2). Increased adhesion of monocytes to BAEC and expression of vascular cell adhesion molecule-1 in response to TNF-α treatment was reduced by pretreatment with hesperetin. In the clinical study, when compared with placebo, hesperidin treatment increased flow-mediated dilation (10.26 ± 1.19 vs. 7.78 ± 0.76%; P = 0.02) and reduced concentrations of circulating inflammatory biomarkers (high-sensitivity C-reactive protein, serum amyloid A protein, soluble E-selectin). CONCLUSIONS Novel mechanisms for hesperetin action in endothelial cells inform effects of oral hesperidin treatment to improve endothelial dysfunction and reduce circulating markers of inflammation in our exploratory clinical trial. Hesperetin has vasculoprotective actions that may explain beneficial cardiovascular effects of citrus consumption.
Bringing Palliative Care into Geriatrics in a Chinese Culture Society—Results of a Collaborative Model between Palliative Medicine and Geriatrics Unit in Hong Kong

improves secondary outcome measurements. The number of reported fractures decreased from before to after the intervention. This could be a result of numerous contributing factors, including medication, environmental awareness, and improvement in physical fitness. Examining adherence to medication recommendations in particular, showed that 15 individuals were identified for prescription of medication to treat osteoporosis. Sixty-seven percent fully complied with this recommendation. Individuals with osteoporosis have a greater risk and prevalence of falls resulting in fractures than those without. The results of this study provide additional evidence that a multidisciplinary falls clinic was effective in reducing the number of falls, the number and severity of injuries, and the amount of medical attention needed. This study also demonstrated that reducing the number of falls is achievable with less geriatrician input than past intervention programs. Future studies using this protocol should consider having the specialist on the team follow up or stress the importance of adherence to the recommendations.
Disparities in the use of chemotherapy and monoclonal antibody therapy for elderly advanced colorectal cancer patients in the community oncology setting.

BACKGROUND The clinical trials on which the treatment of advanced colorectal (CRC) is based enroll few elderly patients. Furthermore, few investigations have determined the use and outcomes of the treatment of advanced CRC in practice. This study evaluated the treatment of advanced CRC in community oncology practices, focusing on age-related differences in treatment and outcome. METHODS A national, retrospective chart review was conducted to evaluate the management of advanced CRC in 10 community practices across the U.S. All medical records of patients diagnosed with advanced CRC initiating chemotherapy treatment after January 1, 2003 through 2006 were included. The primary aim was to compare the proportion receiving doublet chemotherapy (irinotecan or oxaliplatin with a fluoropyrimidine) as initial therapy in young (age <or=65 years) and elderly (age >65 years) patients. Additional aims included age-based comparisons of the addition of bevacizumab to chemotherapy, overall chemotherapy use, all-cause mortality, and toxicity-related events. RESULTS Overall, 520 patients (56% elderly) received 6,253 cycles of chemotherapy. Of the younger patients, 84% received doublet chemotherapy first-line, compared with 58% of elderly patients (p < .001). The use of each of the medications--irinotecan, oxaliplatin, and bevacizumab--was lower in elderly patients (p < .001). Independent predictors of a higher risk for mortality were age >65 (adjusted hazards ratio [HR],1.19; 95% confidence interval [CI], 1.02-1.39) and performance status score >or=2 (HR, 1.65; 95% CI, 1.41-1.91). CONCLUSION Elderly patients are less likely to receive first-line doublet chemotherapy than younger patients. Age and performance status are independent predictors of treatment and overall survival.