Miracle-dz/UniFAR-FTUs huggingface dataset:
Single-Center Experience with Ifosfamide Monotherapy as Second-Line Treatment of Recurrent/Metastatic Osteosarcoma.

BACKGROUND The effectiveness of second-line palliative chemotherapy in patients with recurrent/metastatic osteosarcoma is not well defined. Several small studies (6-19 patients) have reported on ifosfamide as second-line treatment. In this study we report our single-center experience with second-line ifosfamide monotherapy in patients treated for recurrent/metastatic osteosarcoma. METHODS A chart review was conducted of all patients with osteosarcoma treated with ifosfamide from 1978 until 2017. Until 1997 a 5 g/m2 regimen was used, and from 1997 onwards a 9 g/m2 regimen was used. Overall survival (OS) from start of ifosfamide was the primary endpoint. Progression-free survival (PFS) from start of treatment was also studied. To assess difference in survival between groups the log rank test was applied. To investigate the effect of ifosfamide dose and World Health Organization performance status (PS) a Cox proportional hazard regression model was estimated. RESULTS Sixty-two patients were selected with recurrent/metastatic osteosarcoma treated with second-line ifosfamide monotherapy (dose of 5 g/m2, n = 26; 9 g/m2, n = 36). OS was significantly better in univariate analysis for 9 g/m2 compared with 5 g/m2 (10.9 months [95% confidence interval (CI), 9.3-12.6] vs. 6.7 months [95% CI, 5.9-7.6], respectively) and for PS (median OS PS 0, 13.0 months [95% CI, 2.3-23.8]; PS 1, 8.2 months [95% CI, 5.4-11.1]; PS ≥2, 6.2 months [95% CI, 2.2-10.3]; and unknown PS, 5.4 months [95% CI, 2.2-8.5]). In multivariate analysis only PS showed a significant difference. No difference in PFS was found between 5 and 9 g/m2 ifosfamide treatment or PS. CONCLUSION This study suggests that ifosfamide is an effective second-line treatment for patients with recurrent/metastatic osteosarcoma. IMPLICATIONS FOR PRACTICE Ifosfamide monotherapy is commonly used as second-line treatment in osteosarcoma, although large series to support this are lacking. This retrospective study reports overall and progression-free survival for regimens with 5 g/m2 and with 9 g/m2. This study was unable to show a significant difference in survival between 5 and 9 g/m2 but showed an important impact of World Health Organization performance status on overall survival. This study sets a standard and reference for comparison with the multiple phase II studies under development.
Occupational stress facing Nurse Academics - A mixed-methods systematic review.

AIM To better understand occupational stress faced by nurse academics. METHODS A mixed-method systematic review, following the Joanna Briggs Institute [JBI], (2014) process. Studies were assessed for quality and risk of bias by using standardised critical appraisal instruments from the Joanna Briggs Institute. In addition, processes and reporting were checked against the Equator guidelines. See Supplementary File 1. RESULTS The review revealed that nursing academics do experience occupational stress, including burnout. Occupational stress for academic nurses is associated with various factors including work-life balance, workload issues, resources and support, and adapting to change. However, much of the literature focuses on nurses during the initial transition from clinical to academic environment, with rather less focus on established mid-to-late career nurse academics. DISCUSSION Occupational stress and burnout are evident in the university academic workforce, adversely affecting the well-being of academic nurses, and the long-term sustainability of the academic nursing workforce. While there is considerable literature focusing on the novice academic nurse, particularly during the transition period, rather less is known about occupational stress among academic nurses across the career trajectory. Various strategies to deal with the negative consequences of occupational stress are identified, including: (a) quality mentors for novice and younger nursing academics (b) training in resilience building for novice academics (c) supporting collegial relationships and reducing bullying (d) assistance for professional development and research (e) better support and resources to overcome increasing workloads and (f) greater work-related empowerment to enhance job satisfaction. CONCLUSION There is a need for a broader whole-of-career research focus to more fully identify, explore and mitigate the occupational stressors that negatively affect the academic nurse workforce. RELEVANCE TO CLINICAL PRACTICE • A strong and resilient academic nurse workforce is essential for the sustainability of the profession. • Organisations should review their work practices and provide greater work-related empowerment to reduce occupational stressors among nursing academics.
Management of Sciatic Nerve Defects

Abstract Management of sciatic nerve injuries can be difficult for surgeons without a special interest in nerve surgery as they would only treat a handful of such cases for many years. Sciatic nerve defects pose the greatest repair challenges, with nerve grafting producing mixed results because of the large size of the nerve in both diameter and length. This article first presents the peculiarities of sciatic nerve defects management, based on the authors experience and a literature review. Various issues are dealt with: When to operate depending on the injury mechanism? What are the results of nerve autografting and allografting? On which component should the repair focus in very large defects? Subsequently, alternatives to conventional nerve grafting are proposed. The authors stress the usefulness of direct nerve suture with knee flexion at 90 degrees, which permits bridging of gaps as much as 8 cm in length. For larger defects, other procedures should be considered: long vascularized nerve grafting in complete lesions, short grafting with knee flexed, or tendon transfers in partial lesions.
Including culture in programs to reduce stigma toward people with mental disorders in low- and middle-income countries

Stigma is one of the main barriers for the full implementation of mental health services in low- and middle-income countries (LMICs). Recently, many initiatives to reduce stigma have been launched in these settings. Nevertheless, the extent to which these interventions are effective and culturally sensitive remains largely unknown. The present review addresses these two issues by conducting a comprehensive evaluation of interventions to reduce stigma toward mental illness that have been implemented in LMICs. We conducted a scoping review of scientific papers in the following databases: PubMed, Google Scholar, EBSCO, OVID, Embase, and SciELO. Keywords in English, Spanish, and Portuguese were included. Articles published from January 1990 to December 2017 were incorporated into this article. Overall, the studies were of low-to-medium methodological quality—most only included evaluations after intervention or short follow-up periods (1–3 months). The majority of programs focused on improving knowledge and attitudes through the education of healthcare professionals, community members, or consumers. Only 20% (5/25) of the interventions considered cultural values, meanings, and practices. This gap is discussed in the light of evidence from cultural studies conducted in both low and high income countries. Considering the methodological shortcomings and the absence of cultural adaptation, future efforts should consider better research designs, with longer follow-up periods, and more suitable strategies to incorporate relevant cultural features of each community.
Association between depressive symptoms and poor sleep quality among Han and Manchu ethnicities in a large, rural, Chinese population

Objectives To estimate the relationship between sleep quality and depression, among Han and Manchu ethnicities, in a rural Chinese population. Methods A sample of 8,888 adults was selected using a multistage cluster and random sampling method. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Depressive symptoms were assessed via the Center for Epidemiological Survey, Depression Scale (CES-D). Logistic regression was conducted to assess associations between sleep quality and depression. Results The prevalence of poor sleep quality and depression in the Manchus (20.74% and 22.65%) was significantly lower than that in the Hans (29.57% and 26.25%), respectively. Depressive participants had higher odds ratios of global and all sub PSQI elements than non-depressive participants, both among the Hans and the Manchus. Additive interactions were identified between depressive symptoms and ethnicity with global and four sub-PSQI elements, including subjective sleep quality, sleep disturbance, use of sleep medication and daytime dysfunction. Conclusions The findings revealed that the prevalence of poor sleep quality and depression among the Hans was greater than among the Manchus. Depression was associated with higher odds of poor sleep quality.
Vitamin A deficiency and maternal-infant transmission of HIV in two metropolitan areas in the United States

Objective: To determine whether vitamin A deficiency is associated with maternal-infant HIV transmission among HIV-infected pregnant women in two United States cities. Methods: Third trimester serum vitamin A levels were evaluated using high-performance liquid chromatography in 133 HIV-infected women who delivered livebirths during May 1986 to May 1994 and whose infants had known HIV infection status. Results: Sixteen per cent (seven out of 44) of the transmitting mothers and 6% (five out of 89) of the non-transmitting mothers had severe vitamin A deficiency (<0.70 μmol/l; P = 0.05). Maternal-infant transmission was also associated with prematurity <37 weeks gestation (P = 0.02), and Cesarean section delivery P = 0.04), CD4 percentage (p= 0.03) and marginally associated with duration of membrane rupture of ≥4 h (P= 0.06) by univariate analysis. In a multivariate logistic regression model, severe vitamin A deficiency (adjusted odds ratio (AOR), 5.05; 95% confidence interval (CI), 1.20-21.24), Cesarean section delivery (AOR, 3.75; 95% CI, 1.10-12.87), and prematurity (AOR, 2.25; 95%, CI, 1.22-4.13) were asscociated with transmission after adjusting for CD4+ percentage, and duration of membrane rupture. Conclusion: Increased risk of maternal-infant transmission was associated with severe vitamin A deficiency among non-breastfeeding women in these cohorts from the United States.
Identification of Long Non-Coding RNA Expression Profiles and Co-Expression Genes in Thyroid Carcinoma Based on The Cancer Genome Atlas (TCGA) Database

Background Thyroid carcinoma is a malignancy with high morbidity and mortality. Genetic alterations play pivot roles in the pathogenesis of thyroid carcinoma, where long noncoding RNA (lncRNA) have been identified to be crucial. This study sought to investigate the biological functions of lncRNA expression profiles in thyroid carcinoma. Material/Methods The lncRNAs expression profiles were acquired from The Cancer Genome Atlas (TCGA) database according to 510 thyroid cancer tissues and 58 normal thyroid tissues. By using R package edgeR, differentially expressed RNAs were obtained. Also, an overall survival model was established based on Cox regression and clinical data then testified by Kaplan-Meier plot, receiver operating characteristic (ROC)-curve and C-index analysis. We investigated the co-expressed genes with lncRNAs involved in the prognostic model, as well as Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis was conducted R package clusterProfile. Results A total of 352 lncRNAs were identified as differentially expressed in thyroid carcinoma, and an overall survival model consisting of 8 signature lncRNAs was proposed (ROC=0.862, C-index=0.893, P<0.05), 3 of which (DOCK9-DT, FAM111A-DT, and LINC01736) represent co-expressed mRNAs. However, as an oncogene, only FAM111A-DT increased the prognostic risk in thyroid carcinoma. Furthermore, we found differential genes LINC01016, LHX1-DT, IGF2-AS, ND MIR1-1HG-AS1, significantly related to lymph node metastasis (P<0.05). Conclusions In this study, we clarified the differential lncRNA expression profiles which were related to the tumorigenesis and prognosis in thyroid carcinoma. Our results provide new rationale and understandings to the pathogenesis and regulatory mechanisms of thyroid carcinoma.
Long acyl chain ceramides govern cholesterol and cytoskeleton dependence of membrane outer leaflet dynamics

The cellular plasma membrane composition and organization is crucial for the regulation of biological processes. Based on our earlier work showing that the same lipid probe, DiI, exhibits different dynamics in CHO-K1 and RBL-2H3 cells, we investigate the molecular factors that govern these differences. First, we determined that the cytoskeleton-interacting Immunoglobulin E receptor (FcεRI), which is abundant in RBL-2H3 but not in CHO-K1 cells, is not responsible for the DiI confinement found in RBL-2H3 cells. Second, lipid mass spectrometry of the plasma membrane of the two cells indicated differences in ceramide content, especially with long and very long acyl chains (C16 to C24). We, therefore, measure membrane dynamics by imaging total internal reflection fluorescence correlation spectroscopy in dependence on these ceramides. Our results show that C24 and C16 saturated ceramides uniquely alter the membrane dynamics by promoting the formation of cholesterol-independent domains and by elevating inter-leaflet coupling.
Does educational level predict hearing aid self-efficacy in experienced older adult hearing aid users from Latin America? Validation process of the Spanish version of the MARS-HA questionnaire

Hearing aids are the most common rehabilitation strategy for age-related hearing loss. However, 25% to 50% of older adults fitted with hearing aids do not wear them post-fitting. Hearing aid self-efficacy has been suggested as one of the key factors that may explain adherence to hearing aids in older adults. The primary aim of this study was to determine a possible association between educational level and hearing aid self-efficacy in older adult hearing aid users from a Latin American country (i.e., Chile). The secondary aim was to determine if in this sample of older adults, hearing aid self-efficacy predicted hearing aid adherence as previously suggested by other studies. The MARS-HA (Measure of Audiologic Rehabilitation Self-Efficacy for Hearing Aids) questionnaire was used to measure hearing aid self-efficacy. This questionnaire was initially adapted into Spanish (S-MARS-HA) using forward and backward translations by bilingual English-Spanish speakers. A sample of 252 older adults fitted with hearing aids at a public hospital in Santiago, Chile, was investigated. Educational level was measured as the number of years of formal education. Participants responded to the S-MARS-HA along with questions exploring social support, attitudes in using hearing aids, participation in social events, and vision and joint problems. Hearing aid adherence was investigated with the use of a question from the International Outcome Inventory for Hearing Aids. All these procedures were conducted at the participants’ homes. Pure-tone average (PTA; 500–4000 Hz) in the fitted ear was obtained from the participants’ medical records. Univariate and multivariate regression models were constructed to investigate the association between educational level and hearing aid self-efficacy controlling for the covariates of interest (e.g., social support, attitudes in using hearing aids, PTA). The S-MARS-HA showed an adequate construct validity along with a good reliability. Results of the multivariate regression analyses showed that educational level significantly predicted hearing aid self-efficacy. Covariates significantly associated with this outcome included attitudes in using hearing aids and PTA in the fitted ear. Finally, a significant association between hearing aid self-efficacy and adherence to hearing aid use was observed. In conclusion, this study showed a significant association between educational level and hearing aid self-efficacy in older adults from a developing Latin American country. Thus, this variable should be considered when designing and delivering aural rehabilitation programs such as hearing aids to older adults, especially those from developing countries.
A present state of attitudes to cooking in university students, and changes on the attitudes and the skills through a cooking class

A present state of attitudes to cooking in university students, and changes on the attitudes and the skills through a cooking class Naoko Kitano , Natsuki Ganeko , Ikuyo Kawakami , Yumi Ikegami , Kimiko Numata , Nana Nakashima , Hiromi Etoh Prefectural University of Kumamoto, 3 1 -100, Tsukide Kumamoto-shi, Kumamoto, 862-8502 Okayama Prefectural University, 111, Kuboki Soja-shi, Okayama, 719-1197 Shokei University, 2 6 -78, Kuhonji Kumamoto-shi, Kumamoto, 862-8678 Kumamoto University, 2 -401 , Kurokami Kumamoto-shi, Kumamoto, 860-8555 〒862-8502 熊本県熊本市月出 3 1 -100 〒719-1197 岡山県総社市窪木111 〒862-8678 熊本県熊本市九品寺 2 6 -78 〒860-8555 熊本県熊本市黒髪 2 -401
Novel preclinical PET geometrical concept using a monolithic scintillator crystal offering concurrent enhancement in spatial resolution and detection sensitivity: a simulation study

We propose a small-animal PET scanner design combining two sets of monolithic crystals with two different thicknesses. The detectors with thinner crystals serve for high resolution imaging while the thicker crystals retain the detection efficiency. Two small-animal PET models based on 10 and 12 detector blocks made of monolithic LYSO crystals were implemented in the GEANT4 Monte Carlo toolkit. In each of these models, half of the detector blocks consisted of a crystal thickness of 10 mm whereas the second half had a crystal thickness of 2 mm. The scintillator crystals were coupled to SiPM arrays. For the first model, the detector blocks were arranged in a full-ring polygonal geometry in such a way that detector blocks with the same thickness were sitting opposite to each other. For the second model, detector blocks with different crystal thicknesses were facing each other. The performance of the proposed PET models was assessed using standard parameters, including spatial resolution, sensitivity and noise equivalent count rate. Comparison was made with conventional PET models with crystal thicknesses of 2 mm, 6 mm and 10 mm. PET models with a crystal thickness of 2 mm led to the highest spatial resolution (up to 0.6 mm FWHM) at the cost of poor absolute sensitivity (2.5%). On the other hand, PET models with a crystal thickness of 10 mm led to good detection efficiency (4.4%), yet with substantial degradation of spatial resolution (1.2 mm FWHM). The proposed PET models with thick and thin crystals exhibited an optimal trade-off between spatial resolution and sensitivity outperforming the PET model with fixed 6 mm crystal by achieving a spatial resolution of 0.7 mm and absolute sensitivity of 3.7%. The novel proposed PET design concept achieved an optimal trade-off between the sensitivity and spatial resolution by combining two sets of monolithic crystals.
Effect of lncRNA-MIAT on kidney injury in sepsis rats via regulating miR-29a expression.

OBJECTIVE The long non-coding ribonucleic acid (lncRNA)-myocardial infarction associated transcript (MIAT) has been demonstrated to serve as a key regulator in various physiological and pathological processes. This study aims to explore whether lncRNA-MIAT regulates the expression of micro RNA (miR)-29a to affect kidney's injury in sepsis rats. MATERIALS AND METHODS A total of 30 healthy male Sprague-Dawley (SD) rats were randomly divided into experimental group and control group. Rats in the experimental group were injected with lipopolysaccharide (LPS) through the tail vein to prepare the model of sepsis-induced kidney injury, while those in the control group with the equal volume of normal saline. After the levels of serum creatinine (SCr) and blood urea nitrogen (BUN) in rats were determined to ascertain successful modeling, fluorescence quantitative Real-time polymerase chain reaction (qRT-PCR) was performed to measure the expression levels of the lncRNA-MIAT and miR-29a messenger RNAs (mRNAs) in renal tissues. The normal rat kidney epithelial (NRK-52E) cell line was cultured in vitro, and the model was established in vitro via LPS to study the influences of lncRNA-MIAT and miR-29a on the kidney injury in sepsis rats. Moreover, cell apoptosis was detected using Western blotting. RESULTS According to the results of the rat in vivo experiment and NRK-52E cell line in vitro experiment, the model of kidney injury was established successfully, and compared with the control group, experiment group had significantly raised SCr and BUN levels (p<0.01) and a remarkably increased lincRNA-MIAT gene expression level (p<0.01), but a substantially decreased miR-29a gene expression level (p<0.01). Additionally, when the expression of lncRNA-MIAT was up-regulated, the expression of miR-29a was prominently decreased (p<0.01), but that of the cell apoptosis gene cysteine-aspartic proteases (Caspase)-8 protein was remarkably increased (p<0.01). However, the expression of Caspase-8 protein was significantly lowered (p<0.01) once the expression of miR-29a was up-regulated. CONCLUSIONS LncRNA-MIAT may bind to miR-29a to participate in sepsis-related kidney injury.
Regulating pharmacists as contraception providers: A qualitative study from Coastal Kenya on injectable contraception provision to youth

Introduction Young people worldwide are often reticent to access family planning services from public health facilities: instead, they choose to get contraception from private, retail pharmacies. In Kenya, certain contraceptives are available in pharmacies: these include injectables, which can be dispensed but not administered, according national guidelines. However, Kenya struggles with enforcement of its pharmacy regulations and addressing illegal activity. Therefore, in this qualitative study, we assessed private pharmacies as an existing source of injectable contraception for young Kenyans (age 18–24), and investigated the perceived quality of service provision. Methods This study used: focus group discussions (6) with young community members; in-depth interviews (18) with youth who had purchased contraception from pharmacies; key informant interviews with pharmacy personnel and pharmacy stakeholders (25); and a mystery shopper (visiting 45 pharmacies). Results The study found that for injectable contraception, private pharmacies had expanded to service provision, and pharmacy personnel’s roles had transcended formal or informal training previously received–young people could both purchase and be injected in many pharmacies. Pharmacies were perceived to lack consistent quality or strong regulation, resulting in young clients, pharmacy personnel, and regulators being concerned about illegal activity. Participants’ suggestions to improve pharmacy service quality and regulation compliance focused on empowering consumers to demand quality service; strengthening regulatory mechanisms; expanding training opportunities to personnel in private pharmacies; and establishing a quality-based ‘brand’ for pharmacies. Discussion Kenya’s recent commitments to universal health coverage and interest in revising pharmacy policy provide an opportunity to improve pharmacy quality. Multi-pronged initiatives with both public and private partners are needed to improve pharmacy practice, update and enforce regulations, and educate the public. Additionally, the advent of self-administrable injectables present a new possible role for pharmacies, and could offer young clients a clean, discreet place to self-inject, with pharmacy personnel serving as educators and dispensers.