Miracle-dz/UniFAR-FTUs huggingface dataset:
An Exploration of the Challenges for Oncology Nurses in Providing Hospice Care in Mainland China: A Qualitative Study

Objective: Although there has been an increasing emphasis on assisting nurses with providing quality hospice care to patients and family members, few studies have explored the challenges that oncology nurses face when delivering hospice care in the Chinese cultural context. The objective of this study was to elucidate the challenges for oncology nurses in providing hospice care for terminally ill cancer patients in mainland China. Methods: A descriptive qualitative study with purposive sampling using audio-recorded fact-to-face interviews. A total of 13 hospice nurses from four hospitals in Beijing, mainland China, participated in this study. Data collection was from April to June 2019, and thematic analysis method was used to analyze the data. Results: Challenges identified by hospice nurses in providing hospice care for terminally ill cancer patients included: (1) public misperception on hospice care, (2) lack of financial support, (3) fear of medical disputes and legal action, (4) shortage of human resources, (5) insufficient specialization and lack of “hierarchy” training on hospice care, (6) inexperience in communication skills, and (7) lack of self-care and stress management skills. Conclusions: It is imperative and critical for the government, health-care institutions, and hospice care providers to clearly understand the challenges that currently exist in providing hospice nursing. Joint efforts are needed to overcome those challenges, which might result in qualified hospice nurses and provide evidence for further development of hospice care in mainland China.
Using of preservative solutions to improve postharvest life of Rosa Hybrid cv. Black magic

Ornamental products such as cut flowers have a limited display life so the effect of some effective chemical holding treatments on the vase life of rose (Rosa hybrida L.) cv. Black magic cut flowers was studied. In order to find the best treatment in extending cut rose flowers vase life, cut roses were kept in preservative solution including 2.5% sucrose supplemented with 8-hydroxyquinoline citrate, copper sulfate, silver nitrate, aluminum sulfate, ethanol and water (control). All treatment flowers were stored in the climate controlled room at 20±2 ◦ C with 90% RH and 12h photo period using fluorescent lamps (light intensity of 15μmol m -2 s -1 ) at the top of corolla . The result showed that ethanol and aluminum sulfate treatments had the most important role in the extending longevity as well as water uptake in these treatments. Also, there was no significant difference between treatments for leaf and petal dry weight, but the partially high level of water content in aluminum sulfate and ethanol treatments can be effective in increasing vase life. The amount of anthocyanin leakage was high in control. Controls vase life ended at day 9, while the vase life of flowers was kept in aluminum sulfate and ethanol were 18 day.
Metastatic renal cell carcinoma presenting as jaundice with biliary and gastric outlet obstruction. A case report

Abstract Renal cell carcinoma (RCC) can be an aggressive malignancy that has a propensity to spread to atypical locations, most commonly to lung, bone, lymph node. RCC presenting as obstructive jaundice with gastric outlet obstruction has rarely been cited in literature. This study presents a case of advanced RCC in a patient with obstructive jaundice and associated gastric outlet obstruction from a large right renal RCC with malignant retrocaval lymphadenopathy invading the duodenum and distal common bile duct. The patient underwent anterograde stenting of the biliary system via a percutaneous transhepatic cholangiography and an insertion of a duodenal stent. Immunotherapy was commenced and the patient was discharged home. This case highlights the importance of a multi-disciplinary team approach to the management of a complex surgical patient.
Phytoremediation and On-Site Treatment of Septic Effluents in Sub-Surface Flow Constructed Wetlands

Phytoremediation may be one of the mechanisms leading to improvement of water quality in sub-surface flow constructed wetlands. Experiments were undertaken in a glasshouse by growing plants in microcosms, and at a sub-surface flow constructed wetland to evaluate the importance of phytoremediation in improving water quality and the adaptability of different aquatic plants to grow in domestic wastewater from septic tanks. Wastewater was provided every two days to microcosms to simulate detention time in a constructed wetland. An initial screening of 20 plant species resulted in selection of Cyperus alternifolius, C. isocladus, Sagittaria lancifolia, Canna flacccida, Iris sp. , Typha latifolia and T. angustifolia, based on their ability to grow well in the wastewater, for experimentation on phytoremediation. Phytoremediation generally reduced biological oxygen demand, NH4 +-N, P, turbidity, and volatile suspended solids. Populations of fecal coliforms were consistently reduced by 90 to 99% by 2-d detention in.
The possible role of volatile metal compounds in ore genesis

The role of volatility in ore formation is explored by means of free-energy calculations. Assumptions about the composition of the ore fluid are based on the known compositions of volcanic emanations, and the assumptions are justified by the fact that stability ranges for compounds of many metals observed in ore deposits fall within fields outlined by the assumed compositional ranges. The total volatility of a metal under a given set of conditions is determined by the ability of its most stable compound under those conditions to volatilize by itself, to decompose so that the free metal can volatilize, and to form volatile compounds with constituents of the assumed ore fluid. Free energies for such reactions can be calculated from standard chemical data, and with these figures the volatilities can be estimated for a range of values of the temperature and compositional variables. The calculations verify the usual postulate that chlorides are the most important volatile compounds for most metals, but they show further that the effective volatility of a chloride in contact with an ore fluid may be quite different from the simple measured volatility, and may vary enormously not only with the pressure of hydrogen chloride, but also with the oxidation state and sulfur content of the fluid.Calculated volatilities for some metals at high temperatures give concentrations of metal in the ore fluid comparable to experimentally observed concentrations due to complex ions in solution at lower temperatures, suggesting that volatility may indeed play a role in ore transportation. The role is limited to temperatures over 400 degrees C (except for mercury, arsenic, and antimony), and is further practically restricted to the chalcophile metals and possibly to the ferride metals at high pressures of hydrogen chloride. Volatility, therefore, cannot be a general method of ore-metal transportation, but has possible significance in the separation of metals from magmas and zones of high-grade metamorphism, and perhaps in the deposition of some high-temperature ores. Calculations of changes in volatility with temperature and several compositional variables give a great variety of predicted sequences of metal precipitation out of the gas phase. Some of these sequences are strikingly similar to sequences observed in nature; they may provide an explanation for certain paragenetic and zonal relationships in high-temperature ores, but are probably inapplicable at lower temperatures except to quicksilver deposits.In a more general sense, volatility provides a plausible mechanism for the often observed separation of the chalcophile metals from other metals, particularly the metals associated with pegmatites and with deposits in mafic and ultramafic rocks. Still more plausible is an explanation in terms of volatility for the common isolation of mercury, and to a lesser extent of arsenic and antimony, from ores of other metals.
Asset prices and time-varying persistence of consumption growth∗

Inspired by numerous results in the macro literature, we consider a model in which the correlation between shocks to consumption and to expected future consumption growth is nonzero and varies over time. Combined with a negative correlation between consumption growth and uncertainty shocks, representing a precautionary savings effect, our model embeds time variation in consumption growth persistence, which drives variation in the correlation between stock and bond returns, the volatility of stock returns, the so-called “leverage effect,” and the predictive relation between bond yields and future stock returns. Our empirical analysis finds strong support for all of these predictions.
Effect of Lycopene on Oral Squamous Cell Carcinoma Cell Growth by Inhibiting IGF1 Pathway

Purpose Lycopene has produced robust clinical effects and shows a promising chemopreventive in the oral cancer and precancerous lesions. However, much is still unknown about its mechanisms of the carotenoid in protecting against oral squamous cell carcinoma (OSCC). Insulin-like growth factor 1 (IGF1) pathway serves as a key regulatory signal pathway in the tumor microenvironment, which may be associated with the angiogenesis, tumorigenicity, and cancer proliferation. The current study was focused on elucidating the potential pathway played for lycopene to exert its function in treating with OSCC. Materials and Methods Firstly, we explored the dose- and time-response of CAL-27 and WSU-HN6 cells to lycopene. Both cells were incubated with various concentrations of lycopene (0.25, 0.5, 1, 2 µM). The inhibiting rate of cell proliferation was assessed using MTT assay. To observe the regulating effect of lycopene on OSCC, cell migration, apoptosis and tumor formation were detected in vitro and in vivo. The potential signaling pathways of OSCC cells treated with lycopene were analyzed by Affymetrix microarrays. And then, we investigated the changing of IGF1 signaling pathway, on the protein levels of tumor tissue after lycopene. Results Cell proliferation was inhibited by lycopene in a dose- and time-dependent manner. The optimum inhibition efficiencies for OSCC cells were also found. Further, the results also demonstrated that pre-treatment of OSCC with lycopene drastically induced cell apoptosis suppresses cell migration and tumor growth. Mechanistically, ingenuity pathway analysis further revealed that IGF1 pathway participate in killing effects on OSCC after treatment of lycopene. Lycopene may inhibit the pathway by regulating protein expression of IGF1, IGF binding protein (BP) 1, IGFBP3, transcription factor Jun/AP-1 (JUN), and forkhead box O1 (FOXO1). Conclusion These observations indicate that lycopene regulates OSCC cell growth by inhibiting IGF1 pathway, which may be a promising agent for the treatment of OSCC.
Severe COVID-19: A distinct entity

Severe coronavirus disease-2019 (COVID-19) is a distinct entity that rapidly evolves and may abruptly culminate in to a critical illness. As per Chinese experience, approximately, 15% of patients of COVID-19 progress to severe disease and 5% become critically ill. The incidence of severe and critical illness is higher among men, patients older than 65 years of age and in persons with other medical comorbidities. Cytokine storm cause pronounced lung damage and multiorgan failure. Coagulopathy is a key component of severe COVID-19. Critically ill patients are generally predisposed to a high risk of thromboembolism as well. Lymphopenia predisposes to severe disease. None of the antiviral or immunomodulators has proven efficacy in severe COVID-19. Supplemental oxygen need be administered in patients with hypoxemia. Excessive breathing effort, acute respiratory distress syndrome (ARDS), encephalopathy, and multiorgan failure are indications for mechanical ventilation. In a large number of patients, the overall outcome is poor. Health care workers in intensive care units are exposed to the enormous risk of acquiring hospital acquired SARS-COV-2 infection.
Rapid HPLC‐DAD Determination of Furosemide in Tablets Using a Short Home‐Made Column

Abstract Furosemide is a loop diuretic widely used as an antihypertensive. Its analysis, in pharmaceutical formulations, is often required for quality control and to develop new formulations. The aim of this work is to describe the development of a fast chromatographic procedure to determine furosemide in tablets. Adequate sample masses were prepared by dissolution of furosemide in ethanol with the aid of an ultrasonic bath, followed by filtration. After dilution, an aliquot was injected into the chromatographic system. The separations were obtained in a C18 home‐made column (50×4.6 mm, 3 µm) with methanol:phosphate buffer (10 mmol L−1, pH 5.5) (30∶70) as the mobile phase, at a flow rate of 1.0 mL min−1. A photodiode array detector (DAD) monitored signals between 190 and 380 nm, with special attention to 237 nm. The findings were 1.4%–6.2% intra‐assay precision; 1.6%–6.1% interassay precision (day and operator); recoveries of 90.2%, 97.5%, and 109.2% at 90%, 100%, and 110% concentration levels, respectively. The total chromatographic run lasted 3 minutes. By means of peak purity, obtained using the DAD, no interference of concomitants was observed. The residual graphic demonstrates the adequate linearity of the studied concentration interval. The proposed method was applied to commercial samples and shown to be less time and solvent consuming than the procedures previously reported in the literature.
An Experimental Study in a CI Engine Using Nanoadditive Blended Water–Diesel Emulsion Fuel

In this present work, the investigations are carried out to study the performance, emission, and combustion characteristics of a single cylinder Compression Ignition (CI) engine using water–diesel emulsion fuel, and the alumina nanoparticles blended water–diesel emulsion fuels. The water–diesel emulsion fuel is prepared by the emulsification method in the proportion of 83% diesel, 15% water, and 2% surfactants by volume. The alumina nanoparticles are blended with the water–diesel emulsion fuel in the mass fractions of 25, 50, and 100 ppm systematically. The experiments are conducted at a constant speed of 1500 rpm and the results revealed a substantial enhancement in the performance and reduction in the harmful pollutants due to the incorporation of alumina nanoparticles in the water–diesel emulsion fuel. Furthermore, the hot-plate evaporation characteristics test asserted a considerable reduction in the evaporation time by adding the potential alumina nanoparticles to the water–diesel emulsion fuel.
Tolerability and outcome of sunitinib by giving 4/2 schedule versus 2/1 schedule in metastatic renal cell carcinoma patients: a prospective randomized multi-centric Egyptian study

Introduction Sunitinib is a standard of care first line treatment for patients with metastatic renal cell carcinoma (RCC). Sunitinib standard dose is 50 mg once daily for 4 consecutive weeks followed by 2 weeks’ off (4/2 schedule). Long-term and high exposure to this medication lead to severe adverse events (AEs); therefore, this trial was done to find the best schedule which gives the best outcome with minimal toxicity. Materials and methods Seventy patients were randomly assigned into 2 groups, then received 50 mg/day of sunitinib. Group 1 (40 patients) received sunitinib for 4 consecutive weeks followed by 2 weeks off (4/2 schedule) while 30 patients were admitted to group 2 with 2 weeks on and 1 week off (2/1 schedule). Results All patients (100%) had significantly higher AEs on schedule 4/2 vs. 73.3% on schedule 2/1 (p = 0.001). Furthermore, the grade 3 AEs on schedule 2/1 were significantly lower than those on schedule 4/2 (26.7% vs. 82.5%) respectively (p = 0.001), such as fatigue, diarrhea, hypertension, hand foot syndrome (HFS) and mucositis. Progression-free survival (PFS) rate was significantly higher in 2/1 schedule (60.9% vs. 38.6%) than in 4/2 schedule (p < 0.008). Multivariate analysis suggested that: age > 60 years, poor International Metastatic RCC Database Consortium (IMDC) risk category, tumor size > 10 cm and treatment schedule (group 1) were poor prognostic factors of PFS. Conclusions Our study supported the use of 2/1 schedule of sunitinib in patients with metastatic RCC because of lower toxicity profile and better efficacy with improved PFS in comparison to 4/2 schedule.
Diabetes mellitus does not influence results of hepatectomy in hepatocellular carcinoma: case control study

Introduction Patients with diabetes mellitus undergoing hepatectomy for hepatocellular carcinoma (HCC) are at high risk of acquiring perioperative infections. Herein, we investigate the peri-operative impact of diabetes on hepatectomy. Material and methods The surgical outcomes in 363 patients who underwent laparoscopic and open hepatic resection for HCC, with or without diabetes mellitus, were reviewed retrospectively. The association of diabetes mellitus with surgical outcomes and remnant liver regeneration was analyzed. The Student’s t and χ2 tests, Mann-Whitney’s U test, Wilcoxon’s signed-rank test, or Fisher’s exact test were used in the statistical analysis. Results Of the 363 patients, 136 (37.5%) had diabetes, while 227 (62.5%) did not. After propensity score matching, there were no significant differences between the groups in surgical outcomes such as surgery duration, bleeding amount, and postoperative complication rate. No significant differences were observed between the groups in terms of incidence rates of not only infectious complications, including surgical site infection and remote site infection, but also postoperative complication (Clavien-Dindo grade > IIIA), post-hepatectomy liver failure, and massive ascites. There were no differences in the remnant liver regeneration at 7 days and 1, 2, 5, and 12 months following the surgery between the groups (p = 0.076, 0.368, 0.864, 0.288, and 0.063, respectively). No significant differences between the groups in the overall and recurrence-free survival were observed (p = 0.613 and 0.937). Conclusions Remnant liver regeneration in diabetic patients was not morphologically and functionally delayed compared to that in non-diabetic patients. Moreover, diabetes has no effect on the short- and long-term prognosis.
Clinical Outcomes of “U” Route Transforaminal Percutaneous Endoscopic Lumbar Discectomy in Chronic Pain Patients with Lumbar Spinal Stenosis Combined with Disc Herniation

Introduction “U” route transforaminal percutaneous endoscopic lumbar discectomy (PELD) was introduced for lumbar spinal stenosis (LSS) combined with disc herniation (DH) treatment. This study aims to explore the efficacy and safety of “U” route PELD on chronic pain patients with LSS combined with DH. Methods Degenerative LSS combined with DH patients who underwent “U” route PELD were reexamined, and 80 patients were recruited and followed up for 2 years. The other 80 healthy individuals who were age- and sex-matched to the patients without chronic pain were enrolled as healthy controls. Minimum dura sac cross-sectional area (mDCSA) by MRI, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and modified MacNab outcomes were assessed. Emotional evaluation of pain catastrophizing and depression was documented with Pain Catastrophizing Scale (PCS) and Beck Depression Inventory (BDI), respectively, for patients before and after surgery and healthy individuals. Results All patients were of the age range from 47 to 85 years, with an average of 59.5 ± 9.76 years. Symptoms duration was 114.6 ± 22.77 months, operation time was 87.7 ± 25.20 minutes, and the average hospital stay was 5.8 ± 2.81 days. Four patients quit, and hence, a total of 76 patients completed the follow-up. The results indicated that mDCSA was improved significantly after operation (p < 0.001), either low back and leg VAS or ODI decreased over time (p < 0.001), and the excellent-to-good rate was improved from 88.75% to 93.42% during postoperative 2 years (p < 0.05). Complications of dural tear, nerve root, or dysesthesia were reported in 5 patients, and all recovered after conservative therapy. The scores of pain catastrophizing were reduced after operation (p < 0.001), but no significance of BDI was found between patients and healthy controls (p > 0.05). Conclusions The “U” route PELD seems an alternative to LSS combined with DH treatment, which might reach a better decompression and effectively improve chronic pain conditions. Still, the complications were potential and required further consideration.
Influence of boundary layer dynamics on pollutant concentrations over urban region - A study using ground based measurements

Ventilation coefficient (VC) over urban area of Hyderabad, India during night-time in 2008 has been calculated using night-time mixed layer height with boundary layer lidar (BLL) and radiosonde data to investigate the influence of VC on pollutant concentration. Carbon monoxide (CO), ozone (O 3) and black carbon (BC) aerosol mass concentrations in relation to mixed layer height and wind speed have been analysed for different seasons, viz. winter, pre-monsoon, monsoon and post-monsoon associated with boundary layer and ventilation coefficient (VC). The results of the study suggested that VC plays an important role in dispersing the pollutants.
Interactive comment on “Teleconnection between the climates of the Polar Regions during the last ice age” by Xiao Yang and Jose A. Rial

We would like to start our response by thanking both reviewers for their efforts in evaluating and commenting on our manuscript. The reviewers have offered constructive suggestions for a comprehensive and objective discussion of the models to not only base on their skills to reproduce climate records, as done in this study, but also on the abundance and strength of the supporting evidence from past literature. We will integrate these changes into the revised manuscript. At the same time, we found and would like to further clarify some of the misunderstandings in the reviewers’ comments, especially the ones associated with the physical mechanisms of the PhaseSync model and with the concept of phase synchronization itself. We hope that through the following clarifications, we have resolved some of the major criticisms from the reviewers.