Miracle-dz/UniFAR-FTUs huggingface dataset:
Prognostic Understanding at Diagnosis and Associated Factors in Patients with Advanced Lung Cancer and Their Caregivers.

BACKGROUND Prognostic understanding in advanced cancer patients and their caregivers may have an impact on the delivery of effective care. The aims of this study were to explore prognostic understanding at diagnosis in both patients with advanced lung cancer and their caregivers and to investigate correlates of their understanding. SUBJECTS, MATERIALS, AND METHODS A total of 193 patients with newly diagnosed advanced lung cancer and their 167 caregivers were enrolled at 16 hospitals in Japan. We assessed their perceptions of prognosis and goals of therapy and examined their associations with their sociodemographic characteristics, clinical status, quality of life, mood symptoms, and the status of disclosure of information by their treating physicians. RESULTS One fifth of patients and caregivers (21.7% and 17.6%, respectively) mistakenly believed that the patients' cancer was "completely curable. " Substantial proportions of them (16.9% and 10.3%, respectively) mistakenly believed that the primary goal of therapy was to remove all the cancer. Levels of anxiety and depression in both patients and caregivers were significantly higher among those who had accurate understanding of prognosis. In multivariate analyses, inaccurate perceptions of prognosis in patients were associated with sex, better emotional well-being, and lower lung cancer-specific symptom burden. Caregivers' inaccurate perceptions of patients' prognoses were associated with better performance status and better emotional well-being of patients. CONCLUSION Substantial proportions of advanced lung cancer patients and their caregivers misunderstood their prognosis. Interventions to improve their accurate prognostic understanding should be developed with careful attention paid to its associated factors. IMPLICATIONS FOR PRACTICE This study demonstrated that substantial proportions of patients with newly diagnosed advanced lung cancer and their caregivers had misunderstandings about their prognosis. Accurate perceptions of prognosis, which are indispensable in the delivery of effective care, were associated with elevated levels of anxiety and depression in both patients and caregivers, warranting psychosocial care and support for them immediately after diagnosis. Inaccurate perceptions of prognosis in patients were associated with better emotional well-being and lower lung cancer-specific symptom burden. Illness understanding in caregivers was associated with patients' physical and mental status. Those findings provide insight into how they obtain accurate illness understanding.
Anatomy of the Mediterranean Diet and Mortality Among Older Women with Frailty

Abstract We examined individual components of the Mediterranean Diet (Med) and evaluated their relative contribution to mortality rates in older women with frailty. A sample (N = 10,431) included Women’s Health Initiative Observational Study participants aged 65-84 y with complete frailty diagnostic criteria and dietary data. Frailty was assessed with modified Fried’s criteria, and dietary data were collected through food frequency questionnaire. Over a mean follow-up of 12.4 y (range 3–21.0), 3,259 (31.2%) deaths occurred. Crude death rates demonstrated a decrease in mortality with higher intake of individual Med components. However, in the mutually adjusted models, most Med components on their own were not significantly associated with mortality. Exceptions were vegetables, nuts, and whole grains. A higher intake of vegetables, nuts, and whole grains were associated with a significantly decreased hazard of mortality, by 9% (P = 0.02), 13% (P < 0.001), and 17% (P < 0.001), respectively. The relative contribution of these components to diet mortality associations were 21%, 42%, and 57% for vegetables, nuts, and whole grains, respectively. Subgroup analyses by chronic morbidity, smoking status, or excluding women with early death did not substantially change these results.
The Effects of Fillers and Binders on the Accuracy of Tablet Subdivision

The effects of excipients on the accuracy of tablet subdivision are severely underinvestigated. In this study, placebo tablets were prepared using a combined mixture design of fillers and binders to evaluate the effect of these excipients on subdivision accuracy. The responses assessed were mass loss, mass variation, tablet fragmentation, and increased friability. Dicalcium phosphate dihydrate (DCP) gave rise to more uniform and denser tablets than microcrystalline cellulose (MCC), thus resulting in greater subdivision accuracy. The binder type, hydroxypropylcellulose (HPC) or polyvinylpyrrolidone (PVP), did not affect the subdivision of DCP tablets. On the contrary, the structural similarity between HPC and MCC led to improved subdivision accuracy for MCC tablets. A less accurate subdivision was observed in tablets prepared with a DCP–MCC combination; this finding could be attributed to irregular binder distribution in this matrix. An optimized response was built using desirability analysis. This study helps to illuminate the relationship between fillers and binders to guide formulation scientists in the development of tablets with better subdivision performance.
Estimating the impact of an organised screening programme on cervical cancer incidence: A 26‐year study from northern Italy

The impact of the organised cervical cancer (CC) screening programmes implemented in Europe since the 1990s has been insufficiently evaluated. We investigated the changes in CC incidence following the introduction of a screening programme in the Emilia‐Romagna Region (northern Italy). The study period was 1988–2013. The programme, targeting women aged 25–64 years (1,219,000 in 2018), started in 1998. The annual incidence rates that would be expected in 1998–2013 in the absence of screening were estimated, first, by analysing the annual rates in 1988–1997 with a log‐linear model and, second, by analysing the annual rates in 1988–2013 with an age‐period model in which the period effect was enforced to be linear. Cervical adenocarcinoma incidence trend over the entire period was used to validate both estimates. Observed annual rates were compared to the two series of expected ones with the incidence rate ratio (IRR). Incidence remained stable during 1988–1997, peaked in 1998 and then decreased until 2007, when it stabilised. The two series of expected rates were virtually coincident and their trends roughly paralleled the stable adenocarcinoma incidence trend. After 2007, the median IRR was 0.60 (95% confidence interval, 0.45–0.81) based on the log‐linear model and 0.58 (95% confidence interval, 0.34–0.97) based on the age‐period model. Thirty‐six to seventy‐five CC cases were prevented annually for an average annual frequency of 6.5 per 100,000 women in the target population. In summary, consistent circumstantial evidences were obtained that the organised screening programme brought about a 40% reduction in annual CC incidence after 10 years.
The effect of dietary amylose/amylopectin ratio on serum and hepatic lipid content and its molecular mechanisms in growing‐finishing pigs

This study was conducted to investigate the effects of dietary amylose/amylopectin ratio (DAR) on serum and hepatic lipid content, luminal short-chain fatty acid (SCFA) concentrations, and the expression of host genes involved in fat and glucose metabolism in liver and mucosa in growing-finishing pigs. Forty-eight Duroc × Landrace × Large White pigs (49.8 ± 2.8 kg) were randomly allocated to low amylose/amylopectin ratio (LR) and high amylose/amylopectin ratio (HR) groups, each group consisting of six replicates (pen) with four pigs per pen. The DAR was 12/88 for LR and 30/70 for HR. Experiment lasted for 67 days. Results showed that, compared with HR group, ingestion of LR significantly increased the liver total lipid and cholesterol concentration (p < .05) and decreased the serum LDL-C concentration (p < .05). The concentration of propionate, butyrate and total SCFAs in caecum digesta was significantly lower in LR group than in HR group (p < .05). We observed a significant increase in glucose transporter 2 (GLUT2), sodium-dependent glucose transporter 1 (SGLT1) gene expression in LR-fed pigs in the jejunum mucosa (p < .01). A decrease in Na+-coupled monocarboxylate transporter (SMCT1) and free fatty acid receptor 3 (FFAR3) expression was found in the ileum mucosa with LR group (p < .05). Ingestion of LR diet significantly decreased the hexokinase (p < .01) and tend to decrease the pyruvate kinase (p = .050) activities in the liver. Meanwhile, the present results indicated that ingestion of LR diet significantly increased the transcription of gluconeogenesis and lipogenic genes such as forkhead box O1 (FOXO1), fatty acid synthetase3 (FAS3) (p < .05). These findings demonstrated that high amylopectin has harmful effects on hepatic lipid deposit through the modulation of the liver Foxo1 signalling and should be avoided from one's diet.
Antimicrobial activities of endophytic fungi of the Sri Lankan aquatic plant Nymphaea nouchali and chaetoglobosin A and C, produced by the endophytic fungus Chaetomium globosum

ABSTRACT Twenty distinct endophytic fungi were isolated from the surface-sterilized plant parts of Nymphaea nouchali and were identified using morphological and molecular techniques. At 300 µg/disc concentration, eight of the 20 fungal extracts exhibited antimicrobial activities against Staphylococcus aureus (ATCC 25923) and Bacillus cereus (ATCC 11778) while two within the eight showed activity against Pseudomonas aeruginosa (ATCC 9027) and Escherichia coli (ATCC 35218). Furthermore, investigation of the crude extract of Chaetomium globosum resulted in the isolation of two known cytochalasans, chaetoglobosin A and C, and their structures were elucidated and confirmed by mass and nuclear magnetic resonance (NMR) (1H, 13C, COSY, HSQC, HMBC and tROESY) spectral data. Chaetoglobosin A showed antibacterial activities against Bacillus subtilis (MIC 16 µg mL−1), Staphylococcus aureus (MIC 32 µg mL−1) and methicillin-resistant Staphylococcus aureus (MRSA, MIC 32 µg mL−1). This is the first study to report the isolation, identification and antimicrobial properties of endophytic fungi of N. nouchali in Sri Lanka.
Overview of advances in vasculogenic mimicry – a potential target for tumor therapy

Vasculogenic mimicry (VM) describes the process utilized by highly aggressive cancer cells to generate vascular-like structures without the presence of endothelial cells. VM has been vividly described in various tumors and participates in cancer progression dissemination and metastasis. Diverse molecular mechanisms and signaling pathways are involved in VM formation. Furthermore, the patterning characteristics of VM, detected with molecular imaging, are being investigated for use as a tool to aid clinical practice. This review explores the most recent studies investigating the role of VM in tumor induction. Indeed, the recognition of these advances will increasingly affect the development of novel therapeutic target strategies for VM in human cancer.
Effect of sequential therapy on treatment of Helicobacter pylori infection in children.

BACKGROUND Helicobacter pylori infection which plays a major role in the etiology of chronic gastritis and duodenal ulcers in children and adults is one of the commonest chronic infection worldwide. Cure of the infection leads to healing of gastric inflammation and prevention of peptic ulcer. OBJECTIVE The aim of this study was to evaluate the efficacy of the sequential therapy for treatment of Helicobacter pylori infection. MATERIALS AND METHODS In this study, 40 children with symptoms of H. Pylori that the infection was proved by endoscopy and biopsy and rapid urease test (UBT) were enrolled, and received sequential therapy (Lansoprazol, Amoxicillin) for 5 days and (Lansoprazol, Metronidazole and Clarithromycin) for next 5 days. The eradication rate of therapy was evaluated by stool antigen test 6 weeks after completion of therapy. This study was carried out in Pediatric Gastroenterology Clinic of Shiraz University of Medical Sciences, Shiraz, Iran. This study was approved by ethic committee of Shiraz University of Medical Sciences. RESULTS Forty children with mean age of (10.8±4 years) were evaluated. The most common symptom on first admission was epigastric pain (82.5%), with mean duration of symptoms (16±14.5 month). The most common endoscopic findings was redness and erosion of the antrum (55%) and the most pathologic findings was chronic gastritis (77.5%). The most drug adverse effect was nausea (22.5%). The eradication rate of sequential therapy was 82.5%. CONCLUSION Eradication rate of sequential therapy was 82.5% among our cases.
Additional Cervical Lymph Node Biopsy is Not a Significant Prognostic Factor for Nasopharyngeal Carcinoma in the Intensity-Modulated Radiation Therapy Era: A Propensity Score-matched Analysis from an Epidemic Area

Introduction: This study aimed to evaluate the prognostic value of cervical lymph node biopsy and whether different biopsy methods would lead different outcomes in NPC in the intensity-modulated radiotherapy (IMRT) era. Material and Methods: 1492 patients with biopsy-proven, non-metastatic NPC, and treated by IMRT with or without chemotherapy were retrospectively reviewed. Cervical lymph node biopsy was performed in 183 (12.3%) patients: 61(4.1%) by needle puncture and 118(7.9%) by excision biopsy. Propensity-score matching was used to match patients in both arms at an equal ratio. Overall survival (OS), distant metastasis-free survival (DMFS), locoregional relapse-free survival (LRFS), and nodal relapse-free survival (NRFS) were assessed using the Kaplan-Meier method and compared using the log-rank test. Independent prognostic factors were identified using the Cox proportional hazards model. Results: In the original cohort of 1492 patients, patients receiving cervical lymph node biopsy had comparable survival (OS: P = 0.736, DMFS: P = 0.749, LRFS: P = 0.538, NRFS: P = 0.093,) with patients receiving isolated napharynx biopsy. The results for the propensity-match cohort of 316 patients were similar. Interestingly, compared with the control group and needle puncture biopsy group, a slightly lower nodal recurrence rate was observed in the excision biopsy group (P = 0.082 and P = 0.072, respectively). Adjusting for the known prognostic factors in multivariate analysis, cervical biopsy did not cause a higher risk of death, distant metastasis, or nodal relapse. Conclusions: Pretreatment cervical lymph node biopsy is not associated with impaired survival in NPC, suggesting the resist of the biopsy and more aggressive treatment after the biopsy may be unnecessary.
Lung cancer susceptibility from GSTM1 deletion and air pollution with smoking status: a meta-prediction of worldwide populations

Glutathione S transferase mu 1 (GSTM1) gene has been associated with lung cancer (LC) risk, for GSTM1 enzyme playing a vital role in detoxification pathway and protective against toxic insults. The major objective of this study was to investigate GSTM1 deletion pattern and its association with LC in the world’s population by using meta-prediction techniques. The secondary objective was to examine the effects of air pollution, smoking status, and other factors for gene-environment interactions with GSTM1 deletion and LC risk. We completed a comprehensive search to yield a total of 170 studies (40,296 cases and 48,346 controls) published from 1999 to 2017 for meta-analyses. The results revealed that GSTM1 deletion type was associated with increased risk of LC, while GSTM1 present type provided protective effect for all populations combined worldwide. Subgroup analysis on the rank order of risks from highest to lowest, among racial–ethnic groups, were Chinese, South East Asian, other North Asian, European, and finally American. Additional predictive analyses presented that air pollution played a significant role with increased risks of GSTM1 deletion and LC susceptibility, and the risks increased for smokers with higher levels of air pollution. Based on the findings of meta-predictive analysis, increased air pollution levels and smoking status presented additive effects to the LC risk susceptibilities and GSTM1 gene polymorphisms, for gene-environment interactions. Future studies are needed to examine gene-environment interactions for GSTM1 interacting with environmental factors and dietary interventions to mitigate the toxic effects, for LC prevention.
Cancer/testis antigens (CTAs) expression in resected lung cancer

Background Increasing evidence shows cancer/testis antigens (CTAs) play a key role in oncogenesis. Our pre-study finds that MAGEA1, MAGEA10, MAGEB2, KK-LC-1, and CTAG1A/B have high expression frequencies at the protein level. We aim to explore their prognostic role and correlations with clinical characteristics in resected lung cancer at the mRNA level. Methods Thirty-eight surgical lung cancer samples were included. Validation study was performed based on The Cancer Genome Atlas database. The prognostic roles of CTAs were evaluated by Kaplan–Meier and multivariate analysis. Results High expression of MAGEA1 (16.7% vs 65.0%, P=0.004), MAGEA10 (61.1% vs 95.0%, P=0.016), MAGEB2 (55.6% vs 95.0%, P=0.007), and KK-LC-1 (16.7% vs 55.0%, P=0.020) was closely correlated with lymph node metastasis at diagnosis. Patients with TNM stage II or III had a higher expression of MAGEA10 (57.1% vs 91.7%, P=0.034) and KK-LC-1 (14.3% vs 50.0%, P=0.039) compared with patients in TNM stage I. High CTAG1A/B expression showed unfavorable prognosis in all cases (P<0.05). Subgroup analysis showed high CTAG1A/B expression was a negative prognostic factor of survival (P=0.031) in patients with TNM stage II or III. Although no statistical significance was reached, high CTAG1A/B also showed a similar prognostic trend in lung adenocarcinoma (ADC) and squamous cell carcinoma. The Cancer Genome Atlas database showed the negative prognostic role of CTAG1A/B was mainly induced by CTAG1B (NY-ESO-1, P=0.047) and high CTAG1B expression (hazard ratio =2.733, 95% CI: 1.348–5.541, P=0.005) was an independent negative prognostic factor of lung ADC. Conclusion CTAs represent potential candidate targets for immunotherapy and their expression was closely correlated with tumor stage. High CTAG1B expression was an independent negative prognostic factor of lung ADC.
Evaluation of a Brief Suicide Prevention Training Program for College Campuses

Suicide is the second leading cause of death in college students. While research indicates a positive impact of gatekeeper training programs on knowledge and attitudes, few have examined change in suicide prevention behaviors. The purpose of this study was to evaluate the effects of a brief suicide prevention training for college campuses on knowledge, self-efficacy to intervene, and gatekeeper behaviors. A longitudinal design was employed to examine changes from pretest to post-test and 3-month follow-up. Participants included 517 students, staff, and faculty who attended a 90-minute training and completed self-report surveys. The training included both didactic and experiential components. Repeated measures ANOVAs indicated that knowledge, self-efficacy to discuss suicide and to refer to resources, and gatekeeper behavior increased from pretest to post-test and follow-up. Students exhibited a greater increase in gatekeeper behaviors, in comparison to non-students. Large changes were observed on publicizing suicide prevention information and having informal conversations about suicide with students, and 76% had engaged in gatekeeper behavior at follow-up. Findings offer support for the potential efficacy of a brief prevention program, with promising effects on several suicide prevention behaviors. Declines on knowledge and self-efficacy from post-test to follow-up highlight the importance of booster sessions and complementary programming.
Adjunctive lacosamide treatment for adult focal-onset epilepsy: focus on comorbid intellectual/developmental disorders and differing responses

Background Data regarding lacosamide treatment as an adjunctive therapy in patients representative of a focal-onset epilepsy population including those with and without intellectual/developmental disorders (IDDs) are limited. Purpose To evaluate the retention rates of lacosamide in focal-onset epilepsy patients with and without IDD. Patients and methods We retrospectively reviewed all consecutive electronic and paper medical records of patients diagnosed with focal-onset epilepsy who were treated with lacosamide in two tertiary epilepsy centers. Results One hundred and thirty-six patients who met the inclusion criteria were studied. Number of patients with IDD was 46 (33.8%). Median lacosamide dose was 300 mg/day. A total of 39 patients (28.7%) experienced side effects, and 22 of them (16.2%) discontinued lacosamide. The 1-, 2-, and 3-year retention rates of lacosamide in patients with IDD were 68%, 62%, and 53%, respectively. Kaplan–Meier survival analysis showed that the retention rates were significantly lower in patients with IDD when compared to patients without IDD (P=0.04). Cox regression analysis showed that concomitant use of sodium channel blocker antiepileptic drugs (AEDs) was the only independent predictor of retention rate of lacosamide treatment (P=0.03). In the subgroup of patients with IDD, the analysis was performed again and the number of background AEDs was the only predictor for the retention rate of lacosamide (P=0.04). Conclusion When compared to patients without IDD, retention rates of lacosamide adjunctive therapy were lower in patients with IDD. However, these rates were higher than the rates suggested with previously registered AEDs including lamotrigine, levetiracetam, and topiramate. Therefore, irrespective of having comorbid IDD, we might suggest that lacosamide is a well-retained drug with a high efficacy profile in patients with focal-onset epilepsy.
Differences in motor network dynamics during recovery between supra‐ and infra‐tentorial ischemic strokes

Most previous stroke studies have been performed in heterogeneous patient populations. Moreover, the brain network might demonstrate different recovery dynamics according to lesion location. In this study, we investigated variation in motor network alterations according to lesion location. Forty patients with subcortical ischemic stroke were enrolled. Patients were divided into two groups: 21 patients with supratentorial stroke (STS) and 19 patients with infratentorial stroke (ITS). All patients underwent resting‐state functional magnetic resonance imaging and behavioral assessment at 2 weeks and 3 months poststroke. Twenty‐four healthy subjects participated as a control group. To compare altered connectivity between groups, measures used in previous studies to evaluate interhemispheric balance and global network reorganization were investigated and the relationship between network measures and motor functions were examined. Cortico‐cerebellar connectivity was also extracted to investigate its relationship with interhemispheric connectivity. In the STS group, measures related to interhemispheric balance were disrupted compared to the control group 2 weeks poststroke, while this was not found in the ITS group. During recovery, measures related to global network reorganization in the STS group and measures related to interhemispheric balance in the ITS group demonstrated significant changes, respectively. Moreover, motor functions were correlated with altered network measures in both groups. There was an interactive relationship between cortico‐cerebellar and interhemispheric cortical connectivity only in the ITS group. Different changes in the motor network were observed depending on the location of stroke lesions. These results might originate from differences in the interactions between cortico‐cerebellar and interhemispheric connectivity.