Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical treatment of juxta-anastomotic stenosis in radiocephalic fistula. A new proximal radiocephalic anastomosis.

INTRODUCTION The juxta-anastomotic stenosis is the most frequent cause of dysfunction in radiocephalic fistulas for haemodialysis. This adversity can cause low flow or thrombosis. The appropriate treatment of these lesions is under debate. METHOD A prospective study was performed from 1998 to 2009. All dysfunctional radiocephalic fistulas due to juxta-anastomotic stenosis were included (n=96). The diagnosis was made by fistulografy in low flow cases and clinical evidence in cases of thrombosis. The repair was performed using a new proximal radiocephalic anastomosis in all cases. Patency following surgical intervention was estimated with the Kaplan-Meier method. RESULTS A total of 96 proximal radiocephalic anastomoses were performed during the study period. Mean surveillance time was 57.27 months (95% CI: 47.53-67.02). Sixty-six patients were male, and the mean age was 67 years. Scheduled surgery was performed in 70.5% of cases and 29.5% were emergency procedures, 92% of which were ambulatory. Technical success was achieved in 100% without any complications. Mean primary patency at 1, 2, 3, 4, and 5 years was 89.4%, 75%, 70.4%, 65%, and 56%, respectively. Additional procedures (n=16) were required in 14 cases (twelve new proximal anastomoses and four cases of arteriovenous graft placement), resulting in mean secondary patency at 1, 2, 3, 4, and 5 years of 93.7%, 92.1%, 89.6%, 87%, and 82.6%, respectively. Mean secondary patency of initial dysfunctional radiocephalic fistulas at 1, 2, 3, 4, and 5 years was 95%, 95%, 93.2%, 89.1%, and 86.6%, respectively. CONCLUSIONS In our experience the proximal radiocephalic anastomosis can significantly extend fistula functionality in patients with juxta-anastomotic stenosis.
Moonlight shifts the endogenous clock of Drosophila melanogaster

The ability to be synchronized by light–dark cycles is a fundamental property of circadian clocks. Although there are indications that circadian clocks are extremely light-sensitive and that they can be set by the low irradiances that occur at dawn and dusk, this has not been shown on the cellular level. Here, we demonstrate that a subset of Drosophila's pacemaker neurons responds to nocturnal dim light. At a nighttime illumination comparable to quarter-moonlight intensity, the flies increase activity levels and shift their typical morning and evening activity peaks into the night. In parallel, clock protein levels are reduced, and clock protein rhythms shift in opposed direction in subsets of the previously identified morning and evening pacemaker cells. No effect was observed on the peripheral clock in the eye. Our results demonstrate that the neurons driving rhythmic behavior are extremely light-sensitive and capable of shifting activity in response to the very low light intensities that regularly occur in nature. This sensitivity may be instrumental in adaptation to different photoperiods, as was proposed by the morning and evening oscillator model of Pittendrigh and Daan. We also show that this adaptation depends on retinal input but is independent of cryptochrome.
How can structured self‐management patient education improve outcomes in people with type 2 diabetes?

Type 2 diabetes (T2DM) is a long‐term chronic condition that is complex to manage, with the majority of management being done by the person with diabetes outside of the clinical setting. Because of its complexities, effective self‐management requires skills, confidence and the ability to make decisions and choices about treatments and lifestyle on a day‐to‐day basis. Equipping a person with these self‐management skills is in itself challenging and it is now widely accepted that structured education is an integral part of the management of T2DM. This paper explores whether structured self‐management education can improve outcomes in people with diabetes. The authors explore what self‐management education is, why it is needed and then go on to examine the recent evidence from clinical trials from 2006 onwards.
Ethical challenges in providing noninvasive prenatal diagnosis

Purpose of review Noninvasive prenatal diagnosis (NIPD) can potentially allow early detection of fetal genetic disorders, sex, other nonmedical traits, and paternity. We review ethical concerns associated with the imminent introduction of this testing. Recent findings There has been inadequate scientific and medical review of some NIPD tests under development or already available as direct-to-consumer products. Test introduction is largely unregulated and this has prompted calls for greater oversight. As a replacement for current prenatal screening and diagnosis, NIPD may not necessarily identify the same spectrum of disorders. Ethicists are also concerned how women can receive adequate pretest counseling and provide a truly informed consent. Widespread use of NIPD for minor disorders, predispositions, sex, normal human variation and paternity could result in a trivialization of pregnancy termination. Other concerns include the equitable access to testing by all population subgroups. NIPD has the potential to significantly reduce the prevalence of some genetic disorders and thereby change public attitudes about the handicapped and their families. Summary Striking the correct balance between providing only worthwhile testing and ensuring individual patients' reproductive choice will be a major challenge and it is important to begin to address the many ethical issues that NIPD raises.
In vitro susceptibility of Bacillus spp. to selected antimicrobial agents

Although often dismissed as contaminants when isolated from blood cultures, Bacillus spp. are increasingly recognized as capable of causing serious systemic infections. As part of a clinical-microbiological study, 89 strains of Bacillus spp. isolated from clinical blood cultures between 1981 and 1985 had their species determined and were tested for antimicrobial agent susceptibility to 18 antibiotics. Species of isolates were determined by the API 50CH and API 20E systems. Bacillus cereus (54 strains) was the most common species isolated, followed by B. megaterium (13 strains), B. polymyxa (5 strains), B. pumilus (4 strains), B. subtilis (4 strains), B. circulans (3 strains), B. amyloliquefaciens (2 strains), B. licheniformis (1 strain), and Bacillus spp. (3 strains). Microdilution MIC susceptibility tests revealed all B. cereus strains to be susceptible to imipenem, vancomycin, chloramphenicol, gentamicin, and ciprofloxacin. Non-B. cereus strains were most susceptible to imipenem, vancomycin, LY146032, and ciprofloxacin. Disk susceptibility testing suggested that B. cereus was rarely susceptible to penicillins, semisynthetic penicillins, or cephalosporins with the exception of mezlocillin. In contrast, many non-B. cereus strains were susceptible to penicillins, semisynthetic penicillins, and cephalosporins, but marked variability was noted among species.
Some Trace Elements' Level in Alopecia Areata

Background : Alopecia areata (AA) is a non-scarring, inflammatory, hair loss disease with an unpredictable course. It is commonly manifested by patchy areas of complete hair loss on the scalp and other hair-bearing areas in the body that can progress to complete loss of all body hair. AA is a T-cell-mediated autoimmune condition that is most likely to occur in genetically predisposed individuals. Different cytokines such as Interleukin 1 ( IL-1), tumor necrosis factor alpha (TNF-α) and Interferon gamma (IFN-γ) are thought to be involved in the pathogenesis of AA. Proper cell metabolism and effective immune function are dependent on a total of 72 trace elements e.g., zinc (Zn), copper (Cu) and selenium (Se). Disturbances in the levels of Zn, Cu and Se are thought to play a role in the pathogenesis of AA through affecting the levels of different cytokines. Aim of the Work: The aim of this study was to explore the role could be played by the trace elements ( Zn, Cu and Se ) in the pathogenesis of AA. Patients and Methods: This study included 44 patients with a single patch of AA (group I), 36 patients with multiple patches of AA (group II) and 20 healthy control individuals (group III). Venous blood samples were taken from all the participants and then these samples were analyzed by flame atomic absorption spectrophotometer (FAAS) to estimate the serum level of Zn, Cu and Se. Results: There were statistically significant decrease in the serum level of Zn, Cu and Se of both groups of AA patients than controls, but there was no difference in the serum levels of the studied elements between the two groups of AA patients. There was a statistically significant decrease in serum level of Zn and Cu in males of group II than those of group I, also, there was a statistically significant decrease in serum level of Se in the females of group II than group I. There was a statistically significant difference in the serum level of Zn in group I and II in age ≤ 30 and > 30 years. There was a statistically significant decrease in serum level of Zn (group II) than
Evaluation of the pharmacokinetics and metabolism of pembrolizumab in the treatment of melanoma

ABSTRACT Introduction: Advanced melanoma is a devastating disease that has propelled research in therapeutics beyond chemotherapy and radiotherapy. Being highly immunogenic, melanoma is a model tumor for immunotherapy and has highlighted the therapeutic potential of the immune checkpoint inhibitors. Areas covered: This review discusses the pharmacologic properties, clinical efficacy, and safety profile of pembrolizumab, an IgG4-kappa humanized monoclonal antibody against the programmed cell death protein 1 (PD-1) receptor, for the treatment of unresectable or metastatic melanoma. Expert opinion: Pembrolizumab was the first PD-1 inhibitor to be approved by the U.S. Food and Drug Administration (FDA). Remarkably, this accelerated approval for the treatment of advanced, heavily pretreated melanoma was based on response rates alone from a phase I trial. As anticipated, pembrolizumab confirmed a survival advantage in phase II and III trials and has led the way for the study of other drugs that share its mechanism of action. Defining disease and patient characteristics associated with a response remains amongst the most pressing priorities.
Characteristics of consumers using ‘better for you’ front-of-pack food labelling schemes – an example from the Australian Heart Foundation Tick

Abstract Objective The Heart Foundation Tick aims to help consumers make healthier food choices and overcome confusion in understanding food labels. Little is known about what factors differentiate frequent from infrequent users and the effectiveness of this scheme in helping Australians make healthier food choices. Design A cross-sectional survey was used to explore use of the Tick and associations with a range of individual characteristics. Setting A national panel of Australians, living in each state and territory, completed an online survey (n 1446). Subjects Adult men (41 %) and women participated in the study. Results Most trusted the Heart Foundation (79 %), and used the Tick at least occasionally (19 % regularly, 21 % often, 35 % occasionally, 24 % never). A majority was classified as overweight/obese (60 %), 3·5 % were diagnosed with CHD, 5·2 % with diabetes and 23 % with hypertension. Many did not meet recommendations for the consumption of red meat (30 %), processed meat (23 %), vegetables (78 %), fruit (43 %) and fast foods (47 %). Female frequent users tended to have hypertension, be married/de facto, older than 45 years, rural dwellers, and limit their intake of fast foods. Male frequent users tended to have hypertension, meet recommendations for fruit, vegetables and processed meats, but not have a tertiary education. Conclusions The Heart Foundation Tick is a highly trusted, highly recognizable food labelling scheme and helpful to consumers who are motivated to make healthier food choices. More inter-sector collaboration is required to incorporate these schemes into public health campaigns to help consumers make healthier food choices.
Secondary Interventions After Endovascular Thoracic Aortic Repair

Endovascular stent grafting of the descending thoracic aorta has evolved rapidly and is now the standard of care for certain patient subsets. However, the durability of this technique is limited by the development of technique‐specific complications at mid‐term follow‐up. The aim of this study was to evaluate the incidence, techniques, and outcomes of secondary intervention for complications after stent grafting of the descending thoracic aorta.
An MVA-based Vaccine Targeting the Oncofetal Antigen 5T4 in Patients Undergoing Surgical Resection of Colorectal Cancer Liver Metastases

We investigated the use of a therapeutic vaccine, TroVax in patients undergoing surgical resection of colorectal cancer liver metastases. Systemic immunity generated by vaccination before and after resection of metastases was measured in addition to assessing safety and analyzing the function and phenotype of tumor-associated lymphocytes. Twenty patients were scheduled to receive 2 TroVax vaccinations at 2-week intervals preoperatively and 2 postoperatively; if immune responses were detected, 2 further vaccinations were offered. Blood was taken at trial entry and 2 weeks after each vaccination; tumor biopsies were collected at surgery. 5T4-specific cellular responses were assessed by lymphocyte proliferation and enzyme-linked immunosorbent spot, with antibody responses by enzyme-linked immunosorbent assay. Immunohistochemistry characterized the phenotype of tumor-infiltrating lymphocytes. Seventeen of 19 colorectal cancer patients showed 5T4 expression in the liver metastases or surrounding stroma and 18 mounted a 5T4-specific cellular and/or humoral response. In patients who received at least 4 vaccinations and potentially curative surgery (n=15), those with above median 5T4-specific proliferative responses or T-cell infiltration into the resected tumor showed significantly longer survival compared with those with below median responses. Seven of 8 patients who had preexisting proliferative responses to 5T4 were longer-term survivors; these patients showed significantly higher proliferative responses after vaccination than those who subsequently died. These data suggest that the magnitude of 5T4 proliferative responses and the density of CD3 cells in colorectal cancer liver metastases are associated with longer survival. These observations warrant more studies to identify the precise underlying mechanisms.
DK crush (double-kissing and double-crush) technique for treatment of true coronary bifurcation lesions: illustration and comparison with classic crush.

BACKGROUND Classic crush has a lower success rate compared to final kissing balloon inflation (FKBI). We previously reported the double-kissing (DK) crush technique that involves double-kissing along with double-crushing for the treatment of true bifurcation coronary lesions in 2005. METHODS AND RESULTS This is a consecutive, nonrandomized, open-label study. Eighty-eight consecutive patients with single, true coronary bifurcation lesions according to Lefevre Classification2 and side branch diameter >2.0 mm were enrolled. The first 44 patients (from October 2004 to January 2005) were assigned to the classic crush treatment arm and the next 44 patients (from February 2005 to June 2005) were assigned to the DK crush technique arm, respectively. Data within 30 days were analyzed. Patients in the DK crush group, compared to those in classic crush group, were characterized by longer lesion length in the side branch (13.5 +/- 3.4 mm vs 7.8 +/- 3.1 mm; p <0.05), shorter procedural time (44 +/- 12 minutes vs 68 +/- 17 minutes; p <0.05 ), higher success rate of FKBI (100% vs 70%; p <0.01), and lower contrast volume required (102 +/- 38 mm vs 176 +/- 46 mm; p <0.05). There was a trend toward a larger distal angle between the main vessel and the side branch (57 +/- 180 vs 47 +/- 150) in the DK crush group, as well as longer lesion length in the main vessel (24.3 +/- 8.6 mm vs 21.1 +/- 7.3 mm), though without significant differences (p >0.05). Subacute stent thrombosis was detected in 2 patients with failure of FKBI in the classic crush group (4.3%). In addition, patients in the classic crush group were characterized by a smaller minimum lumen diameter (MLD) at the side branch ostium (2.74 +/- 0.12 mm vs 3.01 +/- 0.13 mm; p <0.01) and had a higher degree of residual stenosis at the ostial side branch (17.4 +/- 11.2% vs 7.3 +/- 8.6%; p <0.05). CONCLUSIONS Compared with classic crush, DK crush has the potential to improve the clinical outcome in patients with coronary bifurcation lesions. Further randomized, prospective, multicenter studies are required to confirm these differences between the classic crush and DK crush techniques.
Mycoplasma stimulates the production of oxidative radicals by murine peritoneal macrophages

Mycoplasmas and mycoplasma membranes have been shown to induce the production of inflammatory cytokines, including tumor necrosis factor α and interleukin‐6, as well as nitric oxide, by mouse macrophages and rat brain astrocytes. Luminol‐enhanced chemiluminescence was used as a sensitive method to show that Mycoplasma capricolum membranes induce mouse peritoneal macrophages to produce reactive oxygen radicals. Coincubation of the mycoplasma with a secondary stimulus, namely macrophage‐activating factor or interferon‐γ, increased the chemiluminescence. The augmentation was abolished by the nitric oxide synthase inhibitor N G‐methyl‐l‐arginine, indicating the involvement of nitric oxide. The coproduction of superoxide and nitric oxide by the same cell allows the formation of the powerful oxidant peroxynitrite, which could be responsible for the increased chemiluminescence. Induction of oxidizing radicals by mycoplasmas may contribute to the clinical pathology seen in mycoplasma infections. J. Leukoc. Biol. 57: 264–268; 1995.
A digital phase-locked loop with variable loop gains derived from RLS method

We propose a DPLL (digital phase-locked loop) with time-varying loop gains which are derived from the RLS method. This method, in contrast to the one based on the standard Kalman filtering algorithm, is appropriate for the situation where no statistics are known. If the forgetting factor in the RLS method is constant, the acquisition performance only improves in the initial stage. However, with the variable forgetting factor adaptive to the measurements, the DPLL shows excellent acquisition and tracking performance under a non-stationary environment which are comparable to that based on the adaptive Kalman filter with lock detection algorithm.
Positive Aspects of Caregiving Experience among Caregivers of Patients with Dementia.

OBJECTIVE To assess the positive aspects of caregiving and its correlates among caregivers of patients with dementia. METHODS A total of 55 primary caregivers of patients with dementia were invited to complete the Scale for Positive Aspects of Caregiving Experience (SPACE), Coping Checklist, Social Support Questionnaire, and World Health Organization Quality of Life-BREF version. Caregivers were also assessed by a clinician using the Burden Interview Schedule. Patients were assessed using the Hindi Mental State Examination and Instrumental Activities of Daily Living Scale. RESULTS The mean SPACE domain score was highest for motivation for caregiving role (2.63) followed by caregiver satisfaction (2.54), caregiving personal gains (2.4), and self-esteem and social aspect of caring (2.23). More educated caregivers scored significantly lower in the self-esteem and social aspect of caring. Married caregivers had a higher mean score in the motivation for caregiving role. There were some correlations between subjective burden and various SPACE domains, but the total objective burden score had no correlation with the SPACE. Higher use of avoidance coping was associated with a positive caregiving experience. Stronger social support was associated with higher score in the motivation for caregiving role. Higher level of caregiver burden in various domains was associated with lower motivation for caregiving. Caregiver satisfaction was associated with better quality of life for caregivers in terms of the environment. CONCLUSIONS A positive caregiving experience for primary caregivers of patients with dementia is associated with both objective and subjective burdens, avoidance coping, and perceived social support.
Adjusting for patient selection suggests the addition of docetaxel to 5-fluorouracil–cisplatin induction therapy may offer survival benefit in squamous cell cancer of the head and neck

When induction chemotherapy is used in locally advanced squamous cell cancer of the head and neck (SCCHN), patients often receive cisplatin–5-fluorouracil (PF) followed by radical loco-regional therapy. Phase II studies of docetaxel–cisplatin–5-fluorouracil (TPF) induction therapy, with or without leucovorin (L), have achieved high survival rates versus those reported in phase III PF trials. However, the distribution of prognostic factors may vary between phase II and phase III study populations, making the extrapolation of phase II TPF/L results to phase III PF populations difficult. This study used a patient selection standardization method and Cox model to adjust for potential selection bias. Thus, the survival benefit from adding docetaxel into PF induction regimens in SCCHN could be more accurately assessed. The TPF/L dataset comprised 195 patients from six phase II trials. The PF dataset of 585 patients was derived from five large randomized trials included in the Meta-Analysis of Chemotherapy in Head and Neck Cancer (MACH-NC) database. TPF/L and PF datasets differed significantly concerning the distribution of several prognostic factors. Adjusting for these differences, the relative risk of death in the PF versus TPF/L datasets was 1.85 (95% confidence interval 1.37–2.49), corresponding to a 20% 2-year survival benefit (p<0.0001). Sensitivity analyses confirmed that this improved 2-year survival rate of TPF/L over PF was robust, irrespective of the distribution of studied prognostic factors between treatment datasets. We conclude that this improved survival might be due either to docetaxel's pharmacologic effect or to uncontrolled prognostic factors.
A capability theory of the firm: an economics and (Strategic) management perspective

ABSTRACT The business enterprise is the prime institution in economic development and growth; yet, until recently, mainstream economics has mostly treated firms as homogeneous black boxes managed by untrustworthy agents. Using economic principles, the field of strategic management has developed a nuanced approach to understanding how firms are created, organized, and grow; how they innovate and compete; and how managers manage. That approach has yielded a theoretical framework known as ‘dynamic capabilities’. Contrasts are drawn between dynamic capabilities and other approaches to the theory of the firm, including transaction cost economics and agency theory. The application of capability theory allows intellectual blinders to be removed and an understanding of differential firm-level resource allocation and performance to emerge. This brings a richer conceptual understanding of the nature of the business enterprise and its management consistent with evolutionary and behavioural economics. Policy insights into governance, inequality, economic development, and the wealth of nations follow.