Miracle-dz/UniFAR-FTUs huggingface dataset:
Hysteroscopy and Endometrial Cancer Diagnosis: A Review of 2007 Consecutive Examinations in Self-Referred Patients

The authors reviewed 2007 consecutive outpatient hysteroscopies performed in self-referred women to assess the detection rate of uterine cancer and the validity of different selection criteria for hysteroscopy. Thirty cases of uterine cancer (29 endometrial, 1 carcinosarcoma) were detected. Abnormal uterine bleeding was the indication most commonly associated with cancer (26 of 30 cases, cancer detection rate = 2.1 %), whereas the presence of cervical polyps had no predictive value. Patients age was correlated to cancer detection rate, and the investigation of uterine cancer under the age of 45 was poorly cost effective. Hysteroscopy and endometrial biopsy, performed by Permacurette or Novak curette immediately after hysteroscopy, missed respectively 8 and 2 of 30 cancers. Hysteroscopy should be employed in combination with endometrial biopsy as a standard outpatient investigation whenever endometrial cancer is suspected. These procedures are safe and accurate and rule out more aggressive and costly procedures, such as dilatation and curettage, in most cases.
Inappropriate analysis of reproducibility

undergoing PBSCT (using the same protocol, but without anti-CD20 antibody) was 38 months (unpublished observations), we considered these results unacceptable and the trial was stopped. Salvage therapy with single or multiple additional PBSCT (using a melphalan dose of 100 mg/m 2 ) or with a combination of thalidomide, dexamethasone and zoledronic acid, enabled a second remission to be achieved in all cases. Although the number of patients is too low to draw definitive conclusions, in our experience the use of rituximab as maintenance therapy after PBSCT was associated with an unexpectedly high rate of early relapse in MM patients. Recently, a case of plasma cell leukaemia treated with autologous transplantation and early relapse after consolidation therapy with anti-CD20 antibody, has been reported (Gemmel et al, 2002). The reasons of these findings are not clear. We hypothesize a possible role for rituximab in provoking a further decrease in the residual, normal B-cell activity within the context of the complex immunological network characterizing anti-tumour immune response. The therapeutic role of rituximab in MM remains elusive and requires ad hoc studies.
Online Collaboration Learning: A Way to Enhance Students' Achievement at Kingdom of Bahrain

— The increasing recognition of the need for education to be closely aligned with team playing, project based learning and problem solving approaches has increase the interest in collaborative learning among university and college instructors. Using online collaboration learning in learning can enhance the outcome and achievement of students as well as improve their communication, critical thinking and personnel skills. The current research aims at examining the effect of OCL on the student's achievement at Kingdom of Bahrain. Numbers of objectives were set to achieve the aim of the research include: investigating the current situation regarding the collaborative learning and OCL at the Kingdom of Bahrain by identifying the advantages and effectiveness of OCL as a learning tool over traditional learning, examining the factors that affect OCL as well as examining the impact of OCL on the student's achievement. To achieve these objectives, quantitative method was adopted. Two hundred and thirty one questionnaires were distributed to students in different local and private universities at Kingdom of Bahrain. The findings of the research show that most of the students prefer to use FTFCL in learning and that OCL is already adopted in some universities especially in University of Bahrain. Moreover, the most factors affecting the adopted OCL are perceived readiness, and guidance and support.
Understanding the Mismatch Between Coaches' and Players' Perceptions of Exertion.

A mismatch between the training exertion intended by a coach and the exertion perceived by players is well established in sports. However, it is unknown whether coaches can accurately observe exertion of individual players during training. Furthermore, the discrepancy in coaches' and players' perceptions has not been explained. PURPOSE To determine the relation between intended and observed training exertion by the coach and perceived training exertion by the players and establish whether on-field training characteristics, intermittent endurance capacity, and maturity status explain the mismatch. METHODS During 2 mesocycles of 4 wk (in November and March), rating of intended exertion (RIE), rating of observed exertion (ROE), and rating of perceived exertion (RPE) were monitored in 31 elite young soccer players. External and internal training loads were objectively quantified with accelerometers (PlayerLoad) and heart-rate monitors (TRIMPmod). Results of an interval shuttle-run test (ISRT) and age at peak height velocity (APHV) were determined for all players. RESULTS RIE, ROE, and RPE were monitored in 977 training sessions. The correlations between RIE and RPE (r = .58; P < .01) and between ROE and RPE (r = .64; P < .01) were moderate. The mean difference between RIE and RPE was -0.31 ± 1.99 and between ROE and RPE was -0.37 ± 1.87. Multilevel analyses showed that PlayerLoad and ISRT predicted RIE and ROE. CONCLUSION Coaches base their intended and observed exertion on what they expect players will do and what they actually did on the field. When doing this, they consider the intermittent endurance capacity of individual players.
Suppression of Constitutive and Tumor Necrosis Factor α-Induced Nuclear Factor (NF)-κB Activation and Induction of Apoptosis by Apigenin in Human Prostate Carcinoma PC-3 Cells: Correlation with Down-Regulation of NF-κB-Responsive Genes

Purpose: Development of androgen independence and resistance to apoptosis in prostate cancer are often correlated with high levels of serum tumor necrosis factor (TNF)-α in these patients. The loss of sensitivity to TNF-α-induced apoptosis in androgen-insensitive prostate carcinoma cells is due in part to constitutive activation of Rel/nuclear factor (NF)-κB transcription factors that regulate several cell survival and antiapoptotic genes. Our previous studies have demonstrated growth inhibitory and apoptotic effects of apigenin, a common plant flavonoid, in a variety of human prostate carcinoma cells. Here we examined whether apigenin is effective in inhibiting NF-κB expression in androgen-insensitive human prostate carcinoma cells exhibiting high constitutive levels of NF-κB. Experimental Design: Using androgen-insensitive human prostate carcinoma PC-3 cells, the effect of apigenin was assessed on NF-κB activation by electrophoretic mobility shift assay and reporter gene assay. Expression of NF-κB subunits p65 and p50, IκBα, p-IκBα, in-beads kinase assay and NF-κB-regulated genes were determined by Western blot analysis. Apoptosis was determined by annexin V/propidium iodide staining after fluorescence-activated cell-sorting analysis. Results: Treatment of cells with 10–40-μm doses of apigenin inhibited DNA binding and reduced nuclear levels of the p65 and p50 subunits of NF-κB. Apigenin inhibited IκBα degradation and IκBα phosphorylation and significantly decreased IKKα kinase activity. Apigenin also inhibited TNF-α-induced activation of NF-κB via the IκBα pathway, thereby sensitizing the cells to TNF-α-induced apoptosis. The inhibition of NF-κB activation correlated with a decreased expression of NF-κB-dependent reporter gene and suppressed expression of NF-κB-regulated genes [specifically, Bcl2, cyclin D1, cyclooxygenase-2, matrix metalloproteinase 9, nitric oxide synthase-2 (NOS-2), and vascular endothelial growth factor]. Conclusions: Our results indicate that inhibition of NF-κB by apigenin may lead to prostate cancer suppression by transcriptional repression of NF-κB-responsive genes as well as selective sensitization of prostate carcinoma cells to TNF-α-induced apoptosis.
The impact of empirical studies of spirituality and culture on nurse education.

AIMS AND OBJECTIVES The aim of this paper is to share reflectively how my empirical studies on spirituality and culture have had an impact upon nurse education. BACKGROUND Spirituality and cultural dimensions of care are considered to be integral to holistic care. The healing potentials of spiritual and cultural care are well documented. The commitment to the research programme came due to the concern within early literature on nursing that the provision of spiritual care for patients is inadequate. METHODS The research programme used action research comprising largely qualitative approaches. As the holistic and multiperspective nature of spirituality and culture requires a multidisciplinary approach and flexibility of methodology, various research techniques were used. RESULTS The findings from the research programme led to the development of theories, models and conceptual literature on spiritual and cultural care. In particular, two models evolved from the studies: the ASSET for spiritual cares education and training and the ACCESS for transcultural care practice. The critical incident studies provide insights into nurses' roles in spiritual care interventions. The phenomenological study highlights that chronically ill patients use spiritual strategies in coping with their illness. CONCLUSION Overall, the paper offers a body of evidence that has an impact upon curriculum development in nurse education and nursing practice. RELEVANCE TO CLINICAL PRACTICE The ASSET model offers a framework for spiritual care education. The ACCESS model offers a framework for transcultural care practice. The critical incident studies map out nurses' roles in spiritual and cultural care with scope for development of care intervention models for the future. The coping mechanisms study highlights how patients use spiritual coping strategies such as prayer and other resources to cope with their chronic illnesses.
Zinc: A Trace Element Essential in Vitamin A Metabolism

Zinc is necessary to maintain normal concentrations of vitamin A in plasma. By using animals deficient in both zinc and vitamin A, it was demonstrated that zinc is necessary for normal mobilization of vitamin A from the liver. These results suggest that cases of depressed vitamin A in plasma, unresponsive to vitamin A therapy, may respond to zinc supplementation.
Gene flow between sexual and facultatively asexual lineages of an aphid species and the maintenance of reproductive mode variation

Many organisms considered as strictly clonal may in fact experience some rare events of sexual reproduction with their sexual relatives. However, the rate of sexual–asexual gene flow has rarely been assessed mainly because its evaluation is difficult to achieve in the field. In the cyclically parthenogenetic aphid Rhopalosiphum padi, two main sets of lineages, differing in their investment in sexual reproduction and in their genetic attributes, co‐exist even at a very fine scale: the ‘sexual’ lineages which have a full commitment to the sexual reproduction, and the ‘facultatively asexual’ lineages, which allocate investment in the sexual and parthenogenetic reproduction. This system offers a unique opportunity to tackle the genetic interactions between two contrasting reproductive modes. Here, we provide evidence that gene flow occurred between sexual and facultatively asexual lineages of R. padi. We carefully examined the shuffling in phenotypic and genotypic variation following a sexual reproduction event that took place in the field. Combining genotypic data and phenotypic measurements showed that this gene mixing led to the production of a wide array of reproductive modes, including strictly asexual lineages. Finally, we discuss the central role played by facultatively asexual lineages on the maintenance of reproductive mode variation.
Site Dependence of Postmortem Blood Methadone Concentrations

A case investigated by the Office of the Chief Medical Examiner, State of Maryland, identified methadone at a heart blood concentration of 2.4 mg/L and a subclavian blood concentration of 0.8 mg/L. Due to these discrepant results, a study was undertaken to determine whether such inconsistencies occurred in other methadone cases. Of the 15 cases studied, only four had heart blood and alternate blood concentrations within 20% of one another. In only 53% of the cases were variations of <60% observed. The data failed to show a trend where one site was consistently higher or lower than the other site.
Eigenvalue computation of open periodically composed waveguides by series expansion

Eigenvalues of periodically constituted waveguides with complicated material distribution are efficiently determined, where eigensolvers in software packages show difficulties in finding the eigensolutions. Moreover, the treated waveguide structures are open, causing even more trouble with available numerical solvers or rather demanding procedures within analytical approaches. Since open configurations are essential for the evaluation of radiating structures, we suggest to convert the open problem setting into a closed equivalent configuration but without disturbing the actual field behaviour. Thus, the original continuous mode spectrum is turned into a discrete and proper set of eigenmodes. The field solution of the periodically modified waveguide is obtained by series expansion with the eigensolutions of the homogeneous background waveguide as basis functions. An eigenproblem is still to solve, but it is considerably reduced in size and easy to solve by the use of a-priori information.
Dual Blockade of the Renin-angiotensin-aldosterone System in Diabetic Nephropathy: The Role of Aldosterone

Dual blockade of the renin-angiotensin-aldosterone system (RAAS) with both ACE inhibitors and angiotensin II receptor-blockers has been shown to reduce both albuminuria and blood pressure compared to either monotherapy. The mechanisms behind these beneficial effects are not known, and we hypothesized that the effect of dual RAAS blockade may be due to a more complete suppression of circulating aldosterone. We performed a combined analysis on three randomized, double-masked, cross-over trials where 51 type 1 diabetic patients suffering from diabetic nephropathy received 8 weeks of dual RAAS blockade using an angiotensin II receptor blocker in combination with an ACE inhibitor and 8 weeks of monotherapy with the same ACE inhibitor. Albuminuria, 24 h blood pressure, GFR, and plasma aldosterone were determined at the end of each treatment period. Compared to ACE inhibition alone, dual RAAS blockade lowered blood pressure by 7/5 mm Hg from 137/76 mm Hg, decreased albuminuria by 37% from 558 mg/24 hour, and reduced plasma aldosterone by 28% from 59 pg/ml and caused a reversible decline in GFR of 4 ml/min/1.73 m2 (p < or = 0.01 for all comparisons). There was and a significant correlation between changes in 24-hour diastolic blood pressure and changes in albuminuria. Furthermore, the antialbuminuric response to dual blockade was influenced by the ACE/ID polymorphism, that is, patients carrying the D-allele had a significantly lower reduction of 31% compared to the 55% in patients with the II genotype (p = 0.021). Multiple linear regression analysis revealed that ACE/ID genotypes and reduction in plasma aldosterone, diastolic blood pressure and GFR is associated with changes in albuminuria on dual blockade treatment (R2 (adjusted) = 0.57, p < 0.001). Dual RAAS blockade is a new treatment concept that may offer additional cardiovascular and renal protection in type 1 diabetic patients with diabetic nephropathy. The beneficial response may be influenced by genetic factors and reductions in blood pressure and plasma aldosterone concentrations.
The Association Between PD-L1 Expression and the Clinical Outcomes to Vascular Endothelial Growth Factor-Targeted Therapy in Patients With Metastatic Clear Cell Renal Cell Carcinoma.

BACKGROUND Vascular endothelial growth factor pathway (VEGF)-tyrosine kinase inhibitors (TKIs) are used as the first-line treatment for patients with metastatic clear cell renal cell carcinoma (mCCRCC). Recently, programmed death-1 (PD-1) and programmed death ligand-1 (PD-L1) blockade emerged as promising therapy for renal cell carcinoma. However, the expression pattern and prognostic implication of programmed death-ligands (PD-Ls) in mCCRCC patients receiving VEGF-TKI remain unclear. PATIENTS AND METHODS PD-L1 and PD-L2 expression in tumor cells and the quantities of PD-1+ tumor-infiltrating lymphocytes were immunohistochemically evaluated in 91 mCCRCC patients treated with VEGF-TKI, and their associations with VEGF-TKI responsiveness and clinical outcome were analyzed. RESULTS PD-L1 immunopositivity was observed in 17.6% and significantly associated with a high International Society of Urological Pathology grade (p = .031) and sarcomatoid features (p = .014). PD-L2 immunopositivity was observed in 39.6% and was not associated with any of the assessed clinicopathological variables. PD-L1-positive cases showed poor VEGF-TKI responsiveness (p = .012) compared with PD-L1-negative cases. In univariate survival analysis, PD-L1 immunopositivity was significantly associated with shorter overall survival (OS) (p = .037) and progression-free survival (PFS) (p = .043). Multivariate survival analysis revealed that PD-L1 expression was independently associated with poor OS (p = .038) and PFS (p = .013) in addition to tumor necrosis (p = .006; p = .029, respectively) and Memorial Sloan Kettering Cancer Center score (p = .018; p = .032, respectively). PD-L2 expression was neither associated with VEGF-TKI responsiveness nor patients' outcome. CONCLUSION PD-L1 expression was significantly related to lack of VEGF-TKI responsiveness and independently associated with shorter survival in mCCRCC patients after VEGF-TKI treatment. PD-L1 may have a predictive and prognostic value for determining the value of VEGF-TKI treatment in patients with mCCRCC. IMPLICATIONS FOR PRACTICE Vascular endothelial growth factor pathway (VEGF)-tyrosine kinase inhibitors (TKIs) are essential for the treatment of metastatic renal cell carcinoma patients, but the treatment suffers from a lack of predictive markers. This study demonstrates that PD-L1 expression is a predictor for unfavorable response to VEGF-TKI and a prognostic indicator for poor overall survival and progression-free survival in patients with metastatic clear cell renal cell carcinoma receiving VEGF-TKI.
Foreign Markets Entry Mode Decision for Italian Small and Medium-Sized Enterprises

Using a resource-based view model, this paper examines the main factors influencing Small and Medium-Sized Enterprise (SME) international entry mode selection. In addition, a possible relationship between firms belonging to industrial districts and the entry mode choice has been verified. Data for the analysis of this study were collected interviewing 221 owners/managers of SMEs in Italy. Results showed that entry mode decisions are mainly influenced by firm specific factors. Furthermore, the study does not support the hypothesis of a connection between the firm’s belonging to an industrial district and firms’ behavior in entry mode selection. This study has made it possible to detect by a resource-based perspective the main factors influencing the choice of entry modes.
Economic Growth and the Optimal Level of Entrepreneurship

Using data from the Global Entrepreneurship Monitor (GEM), we examine data from developed and developing countries to estimate the “growth penalty” over 2003–11 when a country’s entrepreneurship deviates from its optimal level. We account for heterogeneity among countries in the optimal entrepreneurship rate, in the growth penalty from deviating from that optimum, and in other factors affecting growth. Notwithstanding that developing countries have more of their population running nascent small firms than in developed countries, a marginal increase in the entrepreneurship rate in developing countries has a positive effect on growth. On the contrary, in developed countries, there is no evident growth penalty. Supplemental results suggest that is because in developed countries as a whole, entrepreneurship is now close to its optimal level, whereas in developing countries the optimal rates of entrepreneurship are much higher. We also explore how the growth penalty varies with characteristics of the country, allowing us to test theories regarding the relationship between entrepreneurship and growth. We show that higher levels of R&D capability decrease the growth penalty of having too few entrepreneurs, suggesting that entrepreneurship and R&D are substitutes. Availability of venture capital also increases the growth penalty, but only in developing countries, where our data on venture capital best proxy its availability to start-ups.
Stimulus pulse‐width influences H‐reflex recruitment but not Hmax/Mmax ratio

It has been proposed that pulse‐widths of 0.5–1.0 ms should be used to evoke H‐reflexes in humans; however, the influence of pulse‐width on H‐reflex recruitment over a range of stimulus intensities has not been well characterized. We constructed soleus H‐reflex vs. M‐wave recruitment curves using 50, 200, 500, and 1000 μs pulses in 12 subjects. In contrast to previous findings, changing the pulse‐width did not significantly alter maximal H‐reflex (Hmax) or M‐wave (Mmax) amplitudes or Hmax/Mmax ratios. In fact, the 1000 μs pulses resulted in larger H‐reflexes when the M‐wave was 5% Mmax; smaller M‐waves at Hmax; and lower H‐reflex thresholds compared with 50 μs pulses. These differences reflect a leftward shift in the H‐reflex vs. M‐wave recruitment curve when using wide vs. narrow pulses and, combined with no change in the Hmax/Mmax ratios, suggest that factors other than antidromic collision in motor axons limit Hmax. These results support the idea that 1000 μs pulses should be used to evoke H‐reflexes and suggest that wider pulses may be beneficial to generate contractions with a greater reflex contribution when using neuromuscular stimulation for rehabilitation. Muscle Nerve, 2007
Nonlinear Processes in Geophysics Resurrecting dead-water phenomenon

We revisit experimental studies performed by Ekman on dead-water ( Ekman, 1904) using modern techniques in order to present new insights on this peculiar phenomenon. We extend its description to more general situations such as a three-layer fluid or a linearly stratified fluid in presence of a pycnocline, showing the robustness of dead-water phenomenon. We observe large amplitude nonlinear internal waves which are coupled to the boat dynamics, and we emphasize that the modeling of the wave-induced drag requires more analysis, taking into account nonlinear effects. Dedicated to Fridtj̈ of Nansen born 150 yr ago (10 October 1861).
The NADH‐ubiquinone oxidoreductase 1 alpha subcomplex 5 (NDUFA5) gene variants are associated with autism

Marui T, Funatogawa I, Koishi S, Yamamoto K, Matsumoto H, Hashimoto O, Jinde S, Nishida H, Sugiyama T, Kasai K, Watanabe K, Kano Y, Kato N. The NADH‐ubiquinone oxidoreductase 1 alpha subcomplex 5 (NDUFA5) gene variants are associated with autism.