Miracle-dz/UniFAR-FTUs huggingface dataset:
Heat shock protein 60 and chromatin assembly factor-1 mRNA levels in hepatitis C virus-related hepatocellular carcinoma and clinical significance

Background: Hepatocellular carcinoma (HCC) is the third cause of cancer-related death worldwide. Heat Shock protein 60 (HSP60), a mitochondrial chaperone, is overexpressed in diverse malignant cells. Chromatin Assembly Factor-1 (CAF-1), a histone chaperone, is down-regulated in quiescent non-proliferating human cells. We aimed to clarify the role of HSP60 and CAF-1 mRNA expression in diagnosis of HCC post-HCV infection. Methods: HSP60 and CAF-1 mRNA levels in urine and blood were quantified by Taqman real-time PCR in 49 subjects; 25 cirrhotic with HCV-related HCC, 12 cirrhotic without HCC and 12 healthy controls. Results: HSP60 and CAF-1 mRNA levels in urine and blood were significantly higher in HCC versus cirrhosis and controls, and in cirrhosis versus controls. Their levels in HCC were significantly increased by advancement of HCC BCLC staging system. HSP60 in urine had 85% sensitivity and 66% specificity at cut off 258354 RU and 85% sensitivity and 60 % specificity at cut off 37576 RU in blood for HCC diagnosis. CAF-1 in urine had 81% sensitivity and 66% specificity at cut off 137756 RU and 77% sensitivity and 64% specificity at cut off 49726 RU in blood for HCC diagnosis. HSP60/CAF-1 sensitivity and specificity in urine and blood were better than either marker alone, with better results in urine (91% and 73%, respectively) than blood (88% and 66%, respectively). Conclusions: HSP60 and CAF-1 in urine and blood may be useful HCC diagnostic markers that were correlated with advancement of HCC with better combined marker sensitivity and specificity than either marker alone especially for urine.
Cytokinetic study of uninfected agarwood branch ethanolic extract on breast cancer cells

Breast cancer is the most common malignancy in women with more than 500,000 global death toll annually. Evidences from ethnopharmaceutical practices showed that Aquilaria spp. from Thymelaeceae family has been used traditionally as treatment of a wide range of disorders. However, scientific evidences are still lacking in order to support the traditional applications on cancer disease. This study was aimed to investigate the cytotoxic kinetics of uninfected agarwood branch ethanolic extract from Aquilaria subintegra against MCF-7 breast cancer cell line that may help understand the effect and provide baseline towards development of agarwood-based therapeutics. Screening assays conducted revealed that the extract may possess anti-attachment and cytotoxic effects against MCF-7 breast cancer cells with a significant inhibition concentration (IC50) of 8 μg/ml when tested using sulforhodamine B (SRB) assay. Extract was subjected to a series of kinetic study in order to investigate the growth rate, death rate, doubling time and death time of MCF-7 between the treated and control groups. Experiments were conducted in triplicates and results obtained showed that the extract reduced the cell generation number of MCF-7 from 3.52 to 1.22 and the growth rate from 0.0421 h-1 to 0.0158 h-1. Doubling time of MCF-7 cells was extended from 16.4 hours to 43.8 hours. The death rate was increased from 0.0058 h-1 to 0.0563 h-1. Closer observation on the population density images revealed that the extract-treated MCF-7 cells showed irregular appearance with blebs, volume reduction, cell shrinking and loss of cell-cell contact. Data collected made it possible to develop an early model of cancer dose treatment using the first order linear equation as a function of time that can be used to estimate cell size or volume of cancer, speed of growth and possibility of successful dosage/treatments using data from biopsy procedure. These findings suggested that agarwood uninfected branch ethanolic extract affect the cytokinetics of MCF-7 cells which warrants further research and focus in validating the hypothesis and elucidating the effects against cancer.
Clinical outcomes and safety in men ≥ 75 and < 75 years with metastatic castration-resistant prostate cancer (mCRPC) treated with enzalutamide in the phase 3 PREVAIL trial.

200 Background: In the phase 3 PREVAIL trial, enzalutamide (ENZA), an androgen receptor inhibitor, improved overall survival (OS) and radiographic progression-free survival (rPFS) relative to placebo (PBO) in chemotherapy-naive men with mCRPC. Methods: PREVAIL randomized 1,717 patients (pts) with asymptomatic or minimally symptomatic chemotherapy-naive mCRPC 1:1 to ENZA 160 mg daily or PBO. Coprimary endpoints were OS and rPFS. This prespecified analysis evaluated the impact of age (≥ 75 vs < 75 years) on efficacy and safety. Results: In PREVAIL, 609 (35%) pts were aged ≥ 75 years. This older subset had several poorer baseline prognostics relative to those aged < 75 years: worse ECOG performance status (ECOG 1: 45.0% vs 24.7%), higher prostate-specific antigen (PSA; 73.3 vs 37.3 ng/mL) and more cardiovascular disease (26.9% vs 16.5%). In both older and younger pts, ENZA improved OS, rPFS and time to PSA progression (Table). Pts aged ≥ 75 years in both the ENZA and PBO groups combined had a higher rate of .
Clinical trials of MPDL3280A (anti-PDL1) in patients (pts) with non-small cell lung cancer (NSCLC).

TPS8123 Background: Blocking the PD-L1/PD-1 immune inhibitory signals can reinvigorate preexisting anticancer immunity and can lead to durable responses in NSCLC. MPDL3280A is a human anti-PD-L1 monoclonal antibody that contains an engineered Fc-domain. MPDL3280A targets PD-L1, preventing binding to its receptors PD-1 and B7.1, thus restoring tumor-specific T-cell immunity. MPDL3280A does not disrupt the PD-L2/PD-1 interaction, which is potentially implicated in autoimmune lung toxicity. In a Phase I study, MPDL3280A led to antitumor responses, with an overall response rate (ORR) of 23% (12/53) in previously-treated NSCLC pts, 46% (6/13) in those pts with a PD-L1 IHC score of 2 or 3 and 83% (5/6) in those pts with a PD-L1 IHC score of 3. Based on these results, we initiated a clinical program examining unselected and PD-L1-positive pts with locally advanced or metastatic NSCLC. Here, we describe the BIRCH and OAK trials. Methods: Both studies require pts aged ≥ 18 y with an ECOG status of 0 or 1 and measu.
ABCG2 and TOP1 mRNA expression as predictive biomarkers for adjuvant FOLFIRI treatment in stage III colon cancer patients: Results from the PETAAC-3 prospective randomized clinical trial.

591Background: FOLFIRI as adjuvant treatment in primary colon cancer was previously tested in two pivotal prospective randomized clinical trials (PETACC-3 and CALGB 89803), both of which failed to demonstrate significant beneficial effects when adding irinotecan to 5FU. As a consequence, FOLFIRI is presently not used as adjuvant treatment for colon cancer. Methods: The study included 580 patients with mRNA expression data performed on tumor samples (FFPE) from stage III colon cancer patients enrolled in the PETACC-3 study, which randomized the patients to 5FU plus Leucovorin +/- irinotecan. Primary end-points were disease free survival (DFS) and overall survival (OS). Median ABCG2 and the 75 percentile TOP-1 mRNA expression data were used to allocate the patients into one of two groups: One with high ABCG2 expression (above median) and low TOP-1 expression (below 75 percentile) (n = 167) and another group including all other combinations of these two genes. Kaplan Meier curves and Cox proportional hazards.
28 Years of Using Hysterectomy Guidelines to Determine the Feasibility of Vaginal Hysterectomy

Aim: To report on 28 years of using the guidelines for hysterectomy to determine the feasibility of vaginal hysterectomy. Methods: Patients with benign disease requiring hysterectomy were assigned type of hysterectomy by guidelines published in1995 according to uterine size, presumed extrauterine disease, and the accessibility of the vagina. Data for consecutive hysterectomies from 1980 to 2008 were collected and assembled into a database. Results: We identified 11,094 patients. The ratio of abdominal to vaginal hysterectomy was 1:92. The indications for hysterectomy were similar to the general population reported by the National Center for Health Statistics (NCHS). Uterine weights for 94.7% of patients were <280 g. Laparoscopy-assisted vaginal hysterectomy, as it was originally described and published in 1990, was used on 1264 patients to verify the presence of presumed severe extrauterine pathology. Vaginal inaccessibility that contraindicated the vaginal approach was present in 109 (1.0%) cases. Conclusion: When the guidelines were followed, the vaginal approach was found feasible in 98.9% (10975/11094) of patients with benign disease. This suggests that following guidelines will increase the currently declining rates of vaginal hysterectomy, which are of concern to the American College of Obstetricians and Gynecologists (ACOG).
Quality of Life in Patients with Thalassemia.

Introduction: Thalassemia patients have experienced a dramatic increase in lifespan secondary to improved and more complicated therapy. The impact of the disease and its treatment on quality of life is largely unknown. Determining the degree of health impairment as perceived by the patient is essential information needed to recommend suitable therapy. Factors that affect the quality of life of thalassemia major patients may differ from thalassemia intermedia patients. Identifying the specific causes for negative patient assessment of overall health status can result in successful intervention. The objective of this study is to determine the factors that affect quality of life in both transfused and non-transfused thalassemia patients. Methods: The Dartmouth Care Cooperative Chart System (COOP) questionnaire is a standardized, validated, visual screening tool that screens the major domains affecting quality of life. Patients rate quality of life from excellent (1) to poor (5). Scores of 1 and 2 are normal. A Score of 3 are mild to moderate impairment, and 4 and 5 are severe abnormalities. 50 patients were randomly selected during a comprehensive visit to complete a COOP questionnaire. These results were augmented by a brief medical history and chart review. Results: Forty-eight thalassemia patients, including 25 transfusion dependent (Tx) and 23 non-transfused (Non-Tx) patients (50% female) were randomly selected and completed the COOP questionnaire. The mean age of the total population was 19 years (0.9–37.9 yrs) and was similar in both groups. Half of both groups had scores of 3 or less indicating no severe impairment. However, 56% of patients had ratings of 3 indicating mild to moderate impairment of major domains. Four patients (2 Tx, 2 Non-Tx) had repeated 4–5 ratings in multiple domains indicating severe impairment of quality of life. The most commonly reported affected domains were feelings, such as anxiety, depression, and concern of overall health status or indications of recent deterioration in health. Conclusion: At least 50% of transfusion and non-transfusion dependent thalassemia patients demonstrate some impairment in quality of life. Forty-four percent of the population had a severe impairment in at least one domain. In particular, mental health issues are widespread. In contrast to previous beliefs, non-transfusion dependent patients also suffer serious impairment in quality of life. This data suggests all patients should undergo quality of life assessments and intervention, which focuses on affected domains. Studies to determine if quality of life affects patients’ adherence to chelation therapy are needed.
Nurses' perceived preparedness of knowledge and skills in caring for patients attacked by Tsunami in Banda Aceh, Indonesia and its related factors

The tsunami disaster, which devastated Southeast Asia on December 26, 2004, resulted in a large number of deaths, caused injury to its thousands of victims physically, emotionally and psychologically, and created irreparable damage to homes and infrastructure. This descriptive correlational study aimed to describe the levels of nurses’ perceived preparedness of knowledge and skills and to investigate the relationship between perceived severity and perceived risk, clinical experience, training and education, and attending hospital disaster drill and nurses’ perceived preparedness of knowledge and skills in caring for patients attacked by tsunami. Systematic random sampling was employed to recruit 97 staff nurses in a hospital in Banda Aceh, Indonesia. Data were obtained through self-reported questionnaires developed by the researcher and her colleague, which including five main parts: demographic data and working information, nurses’ clinical experience, nurses’ perceived preparedness of knowledge, tsunami care for measuring nurses’ perceived preparedness of skills, and perceived severity and perceived risk. Pearson Product Moment correlation was used to investigate iv the relationship between perceived severity and perceived risk, clinical experience, training and education, and nurses’ perceived preparedness of knowledge and skills. Moreover, an independent t-test was used to compare mean differences of nurses’ perceived preparedness of knowledge and skills between attending and none attending group nurses in attending hospital disaster drill. Perceived severity and perceived risk, clinical experience, and training and education were low significantly positively correlated with nurses’ perceived preparedness of knowledge (r =.35, p<.01), (r = .42, p<.01), (r = .32, p<.01) respectively, and with nurses’ perceived preparedness of skills (r = .22, p<.05), (r= .28, p<.01), (r = .33, p<.01) respectively. Interestingly, there was no significant mean differences of nurses’ perceived preparedness of knowledge and skills between attending and none attending group nurses in attending hospital disaster drill (t = -1.55, p= .12), (t = .29, p= .76) respectively. The findings provide evidence to be beneficial for the establishment of nurses’ preparedness both in a clinical setting and nursing curricula.
Pattern of Use, Awareness of Health Hazards, And Effect on Family Relationships among Saudi Blackberry Users

Introduction: One of the life style changes that happened in the Saudi community recently is the widespread use of Smartphones especially the Blackberry (BB). Although, the BB has fewer features than other Smartphones, it is used extensively for communication and business. Studies have shown that all kinds of cellular phones have negative effect on health and interrupt family relationships. The objectives of this study were to assess the pattern of use of BB phones, explore people’s awareness of health hazards associated with their use, and investigate the effect of BB use on family relationships among Saudi people. Methods: Descriptive cross sectional design was used with a convenience sample of 473 participants. Data were collected from the community at Riyadh Shopping Malls and Students at KSAU-HS. Inclusion criteria were the ability to read and write Arabic and to have a BB phone. Eligible participants were asked to provide a consent after explaining the purpose of the study and agreeing to participate. The questionnaire consisted of demographic data and data about pattern of use, awareness of health hazards associated with BB use and questions about effect on family relationships. It was developed in English, then translated into Arabic because data were collected in Arabic. The questionnaire was piloted for applicability before data collection and then modified. Results: 66% of participants were male, 31% were below the age of 20 years old and 64% were in the age group 21 to 40 years old. 71% were university graduates, and 31% working in specialty work. Regarding the pattern of BB use, majority reported that their BB phone was very important to them, they use them most of the time (during classes, breaks, meal time) and internet connection on their phone is important. During sleep, majority keep their phones close to bed and even under the pillow. 54% of participants know and 45% do not know that using BB phones too much would cause health problems. MVA, headache, vision and hearing problems were reported as health hazards that would be associated with the use of the BB phones. In Addition, almost half of participants reported that they chat while sitting with their families and during meal time while they know that extensive use of BB would affect family relationships. Conclusion and recommendation: Although, a considerable number of Saudis are aware that Blackberries might cause health problems, and might affect family relationships, they use them in a broad pattern. A strategy to assess perception and attitude are critical to increase people’s awareness about effective use of such devices. Assessment of health hazards associated with the addiction of BB use is helpful toward building positive attitudes and improving the health of the Saudi population.
Association of Hospital Workload Indicators with Adverse Events: A Retrospective Analysis of Hospital Episode Data

The high prevalence of Adverse Events (AEs) in Australian hospitals and their effects on patient outcomes is a major concern among healthcare service organizations and authorities. The contributing factors which exacerbate this situation, such as the effect of intensified hospital workload on AEs have not been adequately examined in the previous literature. The few studies that have concentrated on the association of hospital workload with AEs have methodological drawbacks due to insufficient numbers of Hospital Workload Indicators (HWIs) employed and the limitation of dimensions that include different types of HWIs. This thesis aims to examine the association of HWIs with AEs using indicators drawn from a hospital episode dataset.
Journeys toward adjustment: Exploring the roleof emotions and beliefs from pre-diagnosis of inflammatory arthritis through the first 12 months

The intention of this thesis is to explore the role of emotions and beliefs from pre-diagnosis of inflammatory arthritis through the first 12 months. Inflammatory arthritis (IA) is an umbrella term for chronic, progressive and systemic auto-immune diseases and for the purpose of this study will include Rheumatoid Arthritis (RA) and Psoriatic Arthritis (PsA). These diseases can progress rapidly, causing synovitis and damaging cartilage and bone around the joints (chapter 1). The impact of these non-curable illnesses is physical and psychological (chapter 2), and may permeate into all aspects of life, (work, families, relationships). However what is unknown is how people in the early stages of IA manage or cope with their diagnosis or whether pre-existing influences (such as Illness Beliefs, chapter 3) have an impact in the first year. If this is understood with more clarity then the clinical team could use appropriate interventions to improve patient care and ultimately outcome. In order to meet the aims a longitudinal hybrid approach (chapter 4) was used. Fifteen participants were followed for the course of a year with interviews pre and post consultation, then at twenty-six and fifty-two weeks. These data were analysed using inductive and deductive thematic analysis based on the framework of Illness Beliefs (chapter 5 and 6). The presentation of the data also included a narrative approach using both the quantitative and qualitative findings (chapter 7). The findings from this study show that even at the end of their first year patients with IA come to their own acceptance, yet each travel in a different journey to reach this outcome. The journeys are determined by coping strategies as patients learn to adjust and adapt by renegotiation and battling through based on a pivot of their own perceived normality. Their definitions of adjustment and adaptation differed from those in the literature and showed lack of consensus across this cohort of patients. The journeys cannot be viewed in isolation but are determined also by social support and the need to be believed, with illness beliefs entwined. From a clinical perspective facilitating communication and tailored education and support at the early stages may reduce distress, and promote flexible coping earlier. Future research needs to develop a greater understanding of these journeys by interviewing a larger cohort of patients and evaluating tailored support programmes.
Standard liver tests

Normal values for laboratory results are defined as those found in 95% of a population. Thus, 2.5% of a population will be above and below the normal values, respectively. But being outside the normal does not immediately reflect illness; that is, a bilirubin level below normal has no clinical consequences. Contrarily, being within the normal value does not necessarily reflect a healthy state. In that regard it has been suggested to use an upper limit of 19 and 30 U/L for ALT for women and men, respectively, to reflect healthy values. This also fits the observed increased mortality in individuals with ALT values that are normal but above the healthy range. Thus, liver transaminases likely will be described as healthy ( 19 U/L for women and 30 U/L for men) and
Mental, neurological and substance abuse disorders: Strategies towards a systems approach

Mental and behavioural disorders account for 12% of the global burden of disease. The WHO, in its World Health Report 2001 has drawn attention to the fact that of the nearly 45 crore estimated to be suffering from mental and behavioural disorders globally, ‘only a small minority’ are adequately cared for. The spending in terms of the country’s mental health budget does not exceed 1% of the total health expenditure. The global prevalence of mental and behavioural disorders among the adult population is estimated to be 10% and contributed to four of the ten leading causes of disability, with one in four families suffering the burden. Depression, anxiety and alcohol use were the commonest disorders in a primary care setting, contributing to nearly 20% of the caseload. It is estimated that by 2020, 15% of the disability-adjusted life-years (DALYs) lost would be due
Exploration of Factors Affecting Nurse Faculty Use or Resistance to Online Education

The convenience of online education coupled with the push for academic progression in nursing has produced considerable growth in online nursing enrollment. Despite the growth, concerns surrounding faculty resistance to online education are present in the literature. While no research studies specifically explore nurse faculty resistance to online education, delivering practice-based education in the online environment has considerably challenged the nurse faculty role. Research reveals a variety of variables that may promote resistance or affect faculty use of online education. This paper defines resistance and addresses prominent faculty concerns associated with teaching online: technology skills and competencies, preparation and training, workload, and quality.