Miracle-dz/UniFAR-FTUs huggingface dataset:
Breaking the Bad News of Cancer: The Patient's Perspective

Objective: Head and neck cancers present a special challenge to the patient and the physician because they affect the quintessential aspects of living such as breathing, eating, and speaking. Numerous articles have described how the physician should perform the difficult task of conveying bad news, but only a small number of articles specifically assess the patients' perceptions when being told of a serious diagnosis. The purpose of this survey was to evaluate the thoughts and concerns of patients receiving diagnoses of head and neck cancer. Study Design: Questionnaire survey. Methods: A 41‐item questionnaire was sent to head and neck cancer patients who have been treated for and remain free of disease for at least 2 years. Results: All of the respondents felt that their diagnosis was adequately explained to them and that no further explanations were necessary. Eighty‐one percent of the respondents did not wish to have anyone else present at the time of diagnosis. Additionally, 75% of the respondents did not want the physician to touch their hands or hug them when given the bad news. Only 63% of the respondents had further discussions with family, friends, or other physicians after being told of their diagnosis. Conclusion: When patients are told of the diagnosis of head and neck cancer, they want their physician to be truthful, caring, and compassionate. The patients want their diagnosis in simple and direct terms without the incorporation of complex medical terminology. The results of this survey can provide insightful information to physicians when they are undertaking the difficult task of conveying bad news to their patients.
Cyclic Guanosine Monophosphate: Elevation in Degenerating Photoreceptor Cells of the C3H Mouse Retina

As a result of an early deficiency in cyclic nucleotide phosphodiesterase activity, guanosine 3',5'-monophosphate accumulates in retinal photoreceptor cells before they begin to degenerate. It is suggested that degeneration of the photoreceptor cells is related to an imbalance in their metabolism or function which is caused by the elevated levels of cyclic guanosine monophosphate.
Outcomes of patients with do-not-intubate orders treated with noninvasive ventilation*

Objective:To determine whether diagnosis and bedside observations predict outcomes of patients who have declined intubation but accept noninvasive positive pressure ventilation (NPPV) to treat their respiratory failure. Design:Prospective multiple-center cohort trial. Setting:Two teaching hospitals and two community-based hospitals in southeastern New England from January through October 1999. Patients:All patients receiving NPPV for acute respiratory failure were screened and enrolled if they had a written do-not-intubate (DNI) order. Interventions:Patients were begun on NPPV with mean inspiratory and expiratory pressures of 13.4 ± 0.3 and 5.0 ± 1 cm H2O, respectively. Respiratory therapists recorded demographic information, blood gases, and ventilator type and settings, and they made bedside assessments of cough strength, presence of airway secretions, awake state, and agitation. Patients were followed until discharge for duration of NPPV, survival status, and disposition. Measurements and Main Results:Of 1,211 screened patients, 114 had a DNI status and were enrolled into the study. Of these, 49 (43%) survived to discharge. Age, gender, location in a community vs. teaching hospital, and initial pH and Pao2 did not affect survival, but a higher baseline Paco2 was associated with a favorable odds ratios for survival to discharge. Diagnosis was an important determinant of survival, with congestive heart failure patients having significantly better survival rates than those with chronic obstructive pulmonary disease, cancer, pneumonia, or other diagnoses. A stronger cough and being awake were also associated with increased probability of survival. Conclusion:Patients with respiratory failure and a DNI status have a high overall mortality rate when treated with NPPV, but those with diagnoses such as congestive heart failure or chronic obstructive pulmonary disease, who have a strong cough, or who are awake have better prognoses. These data should be useful when counseling DNI patients and their families on use of NPPV.
TGFβ produced by IL‐10 redirected astrocytes attenuates microglial activation

While there clearly is an intimate relationship between astrocytes and microglia, few studies have examined these potentially dynamic interactions. In this study, cytokine‐mediated communication between microglia and astrocytes under inflammatory conditions was investigated. We have previously shown that activated microglia produce Interleukin (IL)‐10, a regulatory cytokine that plays an important role in resolving neuroinflammation. Nonetheless, the mechanism by which IL‐10 attenuates pro‐inflammatory cytokine expression in the brain is unclear. Here, we show that IL‐10 redirected astrocytes regulate the activation of microglia in a transforming growth factor (TGF)‐β dependent manner. In support of this concept, astrocytes in the brain maintained higher IL‐10 receptor (IL‐10R1) expression and primary astrocytes in culture were markedly more sensitive to the anti‐inflammatory effects of IL‐10 compared with microglia. Moreover, studies using primary cultures and an astrocyte‐microglia coculture system revealed that astrocytes mediated the anti‐inflammatory effects of IL‐10 on microglia through the production of TGFβ. For instance, only when astrocytes were present did IL‐10 stimulation reduce the expression of IL‐1β and increase expression of anti‐inflammatory mediators fractalkine receptor (CX3CR1) and interleukin 4 receptor‐α (IL‐4Rα) in microglia. Importantly, these IL‐10‐astrocyte dependent effects on microglia were blocked by a TGFβ inhibitor. Furthermore, inhibition of TGFβ signaling in the brain resulted in prolonged sickness behavior and amplified pro‐inflammatory cytokine expression in mice challenged with lipopolysaccharide. Taken together, IL‐10 stimulated the production of TGFβ by astrocytes, which in turn, attenuated microglial activation. Overall, these findings provide novel insight into the mechanisms by which astrocytes modulate microglia under inflammatory conditions. GLIA 2014;62:881–895
Interpersonal and Affective Traits of Psychopathy in Child Sexual Abusers: Evidence from a Pilot Study Sample of Italian Offenders

It has been demonstrated that psychopathy is a crucial construct for the understanding of criminal and violent behavior. However, research on psychopathic traits among child sexual abusers is still scant. In this study, the Psychopathy Checklist–Revised was used to assess psychopathy in a group of 87 Italian, male inmates who were convicted of violent crimes. Child sexual abusers (N = 23) scored higher on the Psychopathy Checklist–Revised interpersonal-affective factor compared to participants who did not perpetrate child sexual abuse. Notably, child sexual abusers showed a very high average score on the Psychopathy Checklist–Revised affective dimension; furthermore, they showed high scores on the two Psychopathy Checklist–Revised items excluded from its two factors–four facets structure (i.e., the items denoting devaluation of intimate relationships). The results of this study may positively inform the development of treatment strategies for child sexual abusers.
A Simple Polarization Reconfigurable Printed Monopole Antenna

A simple polarization reconfigurable printed monopole antenna is proposed for wireless applications. Conducting strips are used to connect to the ground plane providing the necessary additional modes for circular polarization. Linear polarization, right-hand or left-hand circular polarization can be realized using only two PIN diodes, which connect to the ground plane, minimizing their effect on radiation characteristics. The mechanism is described, and key antenna parameters are studied and optimized. The antenna is prototyped and tested for all polarization configurations.
Caspase cleavage of members of the amyloid precursor family of proteins

The synapse loss and neuronal cell death characteristic of Alzheimer's disease (AD) are believed to result in large part from the neurotoxic effects of β‐amyloid peptide (Aβ), a 40–42 amino acid peptide(s) derived proteolytically from β‐amyloid precursor protein (APP). However, APP is also cleaved intracellularly to generate a second cytotoxic peptide, C31, and this cleavage event occurs in vivo as well as in vitro and preferentially in the brains of AD patients ( Lu et al. 2000 ). Here we show that APPC31 is toxic to neurons in primary culture, and that like APP, the APP family members APLP1 and possibly APLP2 are cleaved by caspases at their C‐termini. The carboxy‐terminal peptide derived from caspase cleavage of APLP1 shows a degree of neurotoxicity comparable to APPC31. Our results suggest that even though APLP1 and APLP2 cannot generate Aβ, they may potentially contribute to the pathology of AD by generating peptide fragments whose toxicity is comparable to that of APPC31.
MicroRNA profiling in locally advanced esophageal cancer indicates a high potential of miR‐192 in prediction of multimodality therapy response

To identify possible predictive markers, our study aimed to characterize microRNA (miRNA) profiles of responder and nonresponder in the multimodality therapy of locally advanced esophageal cancer. Initially, a microarray‐based approach was performed including eight patients with esophageal cancer. Patients received neoadjuvant chemoradiation followed by surgical resection. Major histopathological response was defined if resected specimens contained less than 10% vital tumor cells (major/minor response: 4/4 patients). Intratumoral RNA was isolated from both, pretherapeutic tissue biopsies in addition to corresponding surgical specimens. The profile of 768 miRNAs was analyzed in 16 specimens (preneoadjuvant and postneoadjuvant therapy). Selected miRNAs were than analyzed on pretherapeutic and post‐therapeutic biopsies of 80 patients with esophageal cancer, who underwent multimodality therapy (major/minor response: 30/50 patients). Comprehensive miRNA profiling identified miRNAs in pretherapeutic biopsies that were significantly different between major/minor responders. Based on the microarray results, miR‐192, miR‐194 and miR‐622 were selected and the dysregulated miRNAs were studied on an extended series of esophageal cancer patients. The expression of miR‐192, miR‐194 and miR‐622 was significantly reduced after neoadjuvant therapy confirming the array profiling data. Importantly, the pretherapeutic intratumoral expression of miR‐192 and miR‐194 was significantly associated with the histopathologic response of esophageal squamous cell carcinoma to multimodal therapeutic treatment. Therefore, in patients with locally advanced esophageal cancer undergoing neoadjuvant chemoradiation followed by esophagectomy, miR‐192 and miR‐194 in pretherapeutic biopsies are considered as indicators of major histopathologic regression.
Beta-cell reserve capacity in chronic pancreatitis.

The degree of correlation between exocrine pancreatic function and endocrine secretory capacity was examined in 13 chronic pancreatitis patients with secondary diabetes mellitus, 8 chronic pancreatitis patients without diabetes, and 11 healthy subjects. The two parameters were studied under maximal stimulation (volume-corrected secretin-pancreozym test and glucose-tolbutamide-glucagon provocation, respectively). A close, linear correlation was found between all endocrine variables and pancreatic acinar function (e.g. rs = 0.77 for chymotrypsin output and C-peptide release; p less than 0.0001). The correlation was less strong with pancreatic bicarbonate output (e.g. rs = 0.49 for C-peptide release; p less than 0.05). In our patients, secondary overt diabetes occurred in chronic pancreatitis when protease outputs were, on an average, reduced to about 10% of the mean maximal protease output of normal subjects.
Human telomerase RNA component expression in Spitz nevi, common melanocytic nevi, and malignant melanomas

Background: Telomerase is a ribonucleoprotein DNA polymerase that is capable of synthesizing telomeres onto the ends of chromosomes. The cumulative loss of telomerase activity is believed to be associated with cell senescence. Telomerase activity has been shown to be higher in malignant melanomas than in common melanocytic nevi. The aim of the present study was to elucidate the pattern of expression of the human telomerase RNA (hTER) component in routinely processed specimens of Spitz nevi, malignant melanomas, and ordinary melanocytic nevi.
Antipsychotic drug treatment in ambulatory dementia care: prevalence and correlates.

BACKGROUND The present study is the first to analyze primary data about the use of antipsychotic drugs among community dwelling people with dementia in German primary care. OBJECTIVES To determine (1) prevalence of antipsychotic drug treatment in German primary care patients who screened positive for dementia and (2) factors associated with antipsychotic drug treatment. METHODS DelpHi-MV (Dementia: life- and person-centered help in Mecklenburg-Western Pomerania) is an ongoing general practitioner-based, randomized, controlled intervention trial. A total of 4,064 community dwelling patients (≥70 years) recruited from 108 participating practices were screened for dementia (DemTect <9). Of 692 eligible patients (17%), a total of 406 patients provided informed consent (59%). Present analyses are based on data of 243 patients who completed baseline assessment before January 2014 (preliminary data). RESULTS Of the 243 patients who screened positive for dementia, a total of 25 patients (10%) received at least one antipsychotic drug. Atypical antipsychotic drugs (64%) were prescribed more often than typical antipsychotic drugs (36%). The results of the multivariate analysis showed that treatment by a specialist (neurologist/psychiatrist) was the only factor significantly associated with antipsychotic drug treatment (odds ratio, 12.86; p < 0.05; 95% confidence interval, 1.04-158.71). CONCLUSIONS Compared to the antipsychotic drug treatment rate among people with dementia living in nursing homes (>50%), the rate we found for community dwelling primary care patients who screened positive for dementia was low. Further research is needed to evaluate if these patients are adequately treated or if the antipsychotic drug treatment should and could be further reduced.
Turbulent cascade of Kelvin waves on vortex filaments

By numerically integrating in time the motion of vortex filaments, we study how the nonlinear interaction of Kelvin waves along vortices generates Kelvin waves of larger and larger wavenumbers (smaller and smaller wavelength). At sufficiently large wavenumbers the angular velocity of the vortices is large enough that kinetic energy is lost by sound emission. This turbulent cascade of Kelvin waves should explain why turbulence, generated in superfluid helium at very low temperature near absolute zero, quickly decays, despite the lack of any viscous dissipation.
Lipid Raft-Independent B Cell Receptor-Mediated Antigen Internalization and Intracellular Trafficking1

The Ag-specific B cell receptor (BCR) expressed by B lymphocytes has two distinct functions upon interaction with cognate Ag: signal transduction (generation of intracellular second messenger molecules) and Ag internalization for subsequent processing and presentation. While it is known that plasma membrane domains, termed lipid rafts, are involved in BCR-mediated signal transduction, the precise role of plasma membrane lipid rafts in BCR-mediated Ag internalization and intracellular trafficking is presently unclear. Using a highly characterized model system, it was determined that while plasma membrane lipid rafts can be internalized by B lymphocytes, lipid rafts do not represent a major pathway for the rapid and efficient internalization of cell surface Ag-BCR complexes. Moreover, internalized plasma membrane lipid rafts are delivered to intracellular compartments distinct from those to which the bulk of internalized Ag-BCR complexes are delivered. These results demonstrate that B lymphocytes, like other cell types, possess at least two distinct endocytic pathways (i.e., clathrin-coated pits and plasma membrane lipid rafts) that deliver internalized ligands to distinct intracellular compartments. Furthermore, Ag-BCR complexes differentially access these two distinct internalization pathways.
Recognition of Gonadotroph Adenomas in Women

BACKGROUND Pituitary adenomas that arise from the gonadotroph cells are being recognized with increasing frequency in men, but they are still rarely recognized in women. This rarity could be the result of an actual difference in occurrence or of greater difficulty in recognition. The tumors are usually recognized in men more than 50 years old, but elevated serum gonadotropin levels in women of that age could be produced by normal gonadotroph cells. METHODS Because the stimulation of follicle-stimulating hormone (FSH), luteinizing hormone (LH), and the beta subunit of LH (LH beta) by thyrotropin-releasing hormone (TRH) is a characteristic of gonadotroph adenomas in men, we administered TRH to 16 women with apparently nonsecreting pituitary macroadenomas and measured serum FSH, LH, LH beta, and the glycoprotein hormone alpha subunit every 15 minutes for 90 minutes before and 90 minutes after. The results were compared with the responses in 16 healthy women matched for age and in 10 women with macroadenomas secreting prolactin, growth hormone, or corticotropin. The tumors from 12 of the women with nonsecreting adenomas were cultured, and the secretion of FSH, LH, and LH beta in culture was determined. RESULTS Eleven of the 16 women with apparently nonsecreting adenomas had significant increases in serum LH beta in response to TRH, 3 had FSH responses, and 4 had LH responses. None of the 16 healthy women and none of the 10 women with secreting macroadenomas had LH beta, FSH, or LH responses to TRH. Ten of the 12 adenomas that were cultured secreted readily detectable amounts of FSH, LH, and LH beta, and their secretion in vitro correlated with the patients' responses to TRH in vivo. CONCLUSIONS Most apparently nonsecreting pituitary macroadenomas in women arise from gonadotroph cells. The majority of these can be recognized, even in postmenopausal women, by the serum LH beta responses to TRH, and some can be recognized by the responses of serum FSH and LH.
A Ras1‐Cdc24 signal transduction pathway mediates thermotolerance in the fungal pathogen Cryptococcus neoformans

Pathogenic microorganisms must precisely regulate morphogenesis to survive and proliferate within an infected host. This regulation is often controlled by conserved signal transduction pathways that direct morphological changes in varied species. One such pathway, whose components include Ras proteins and the PAK kinase Ste20, allows the human fungal pathogen Cryptococcus neoformans to grow at high temperature. Previously, we found that Ras1 signalling is required for differentiation, thermotolerance and pathogenesis in C. neoformans. We show here that the guanine nucleotide exchange factor Cdc24 is a Ras1 effector in C. neoformans to mediate the ability of this fungus to grow at high temperature and to cause disease. In addition, we provide evidence that the Ras1‐Cdc24 signalling cascade functions specifically through one of the three Cdc42/Rac1 homologues in C. neoformans. In conclusion, our studies illustrate how components of conserved signalling cascades can be specialized for different downstream functions, such as pathogenesis.
A Critical Function of Th17 Proinflammatory Cells in the Development of Atherosclerotic Plaque in Mice

Considerable evidence supports that the CD4+ T cell-mediated immune response contributes to the development of atherosclerotic plaque. However, the effects of Th17 cells on atherosclerosis are not thoroughly understood. In this study, we evaluated the production and function of Th17 and Th1 cells in atherosclerotic-susceptible ApoE−/− mice. We observed that the proportion of Th17 cells, as well as Th1, increased in atherosclerotic ApoE−/− mice compared with nonatherosclerotic wild-type littermates. In ApoE−/− mice with atherosclerosis, the expression of IL-17 and retinoic acid-related orphan receptor γt was substantially higher in the arterial wall with plaque than in the arterial wall without plaque. Increased Th17 cells were associated with the magnitude of atherosclerotic plaque in ApoE−/− mice. Importantly, treatment of ApoE−/− mice with neutralizing anti–IL-17 Ab dramatically inhibited the development of atherosclerotic plaque, whereas rIL-17 application significantly promoted the formation of atherosclerotic plaque. These data demonstrate that Th17 cells play a critical role in atherosclerotic plaque formation in mice, which may have implications in patients with atherosclerosis.
Effect of Type of Cause on Attitudes toward Mental Illness and Relationships between the Attitudes

The effects of four types of supposedly causative factors on judgements of mental illness, social distance, and prognosis were assessed among university students. Correlations bet ween the components of attitudes were also examined. A vignette format was utilized. Analysis showed that the etiology of the case and the sex of the respondents had no significant influence except for sex in only one social distance item. However, there were statistically nonsignifi cant tendencies. Correlations revealed few significant relationships between the components of attitudes. The results are considered to be in line with previous research in the sense that attitudes toward mental illness are not highly structured.
Analysis of brain connectivity patterns in autistic children during watching emotional faces

Autism is a neurodevelopmental disorder that changes the normal brain function. Several studies have reported that the patterns of brain connectivity in autistic and healthy individuals are different. In this paper the effective connectivities of autistic and healthy children were measured through Granger Causality and then applied as discriminant features to separate the two groups. To estimate the connectivity, EEG signals of six autistic children and 12 healthy ones (7–10 years old) were recorded in different emotional states (eyes- closed, eyes-open, watching happy, sad and neutral faces). Using the Granger based connectivity features and SVM classifier, the recognition rates in states of eyes-closed, eyes-open, happy, sad and neutral, were obtained 87.6%, 89.4%, 86%, 91.9%, and 83.1%, respectively. Discrimination of autistic and healthy children in different emotional states, is improved using Granger causality-based connectivity features. This is due to consideration of temporal changes of all channels in measuring connectivity between two particular channels. This improvement is more evident in the sad emotional state.
Chronic knee extensor mechanism lesions in total knee arthroplasty: a literature review

Abstract Knee extensor mechanism rupture is a serious complication of total knee arthroplasty (TKA). Its prevalence ranges from 1 to 10% and it is commonly observed as a chronic multifactorial pathology with the patellar tendon as the most common site of rupture. Knee extensor mechanism reconstruction can be performed using allogenic or synthetic grafts. In the literature it is still not clear whether one of these techniques is superior to the other and the choice is usually tailored to the patient case by case. Allografts allow better restoration of the anatomical landmarks, whereas the mesh technique is more reproducible and the graft does not elongate over time. Allografts carry an increased risk of infection compared with synthetic reconstructions, while the mesh technique is cheaper and more readily available. In this paper, we review the etiology, diagnosis and treatment of this pathology, drawing on the most recent literature.