Miracle-dz/UniFAR-FTUs huggingface dataset:
Treatment Patterns and Health Resource Use Among Patients with Metastatic Gastroenteropancreatic Neuroendocrine Tumors Treated at a Tertiary Referral Center

Abstract Background Although an increasing number of treatments have become available for patients with advanced gastroenteropancreatic neuroendocrine tumors (GEP‐NETs), there remains little consensus on treatment sequence and its impact on health care resource use (HRU). We sought to describe treatment patterns and HRU, in a cohort of patients with metastatic GEP‐NETs treated at a tertiary referral center in the U.S. Materials and Methods We identified patients with a well‐differentiated, metastatic GEP‐NET evaluated at Dana‐Farber Cancer Institute between July 2003 and May 2015. For these patients, we describe the sequence of treatment regimens received for their disease, together with associated HRU. Results We identified 682 patients with advanced GEP‐NETs. Of these patients, 597 (87.0%) initiated ≥1 treatment over the follow‐up period. The mean age at diagnosis was 58.5 years, 50.2% were men, and 94.0% were white. A total of 83.1% initiated a somatostatin analog (SSA) as their first‐line treatment, with 55% and 31% of patients continuing with second‐ and third‐line therapies. A total of 31.2% of patients with SSAs underwent dose escalation to above standard dose. In this setting, patients with pancreatic neuroendocrine tumors were more commonly treated with cytotoxic regimens than other NET tumor types and also had higher HRU. Conclusion Our study suggests that, at a tertiary referral center, patients with advanced NETs commonly received multiple courses of treatments. Our data suggest a clear preference for use of SSAs as a first‐line treatment for patients with advanced NETs, with SSAs commonly escalated and continued throughout the course of treatment in combination with other regimens. Implications for Practice The current study demonstrates the common use of somatostatin analog as a first‐line therapy for patients with advanced gastroenteropancreatic neuroendocrine tumors as well as the incorporation of multiple different treatment regimens in the treatment course of patients with this disease.
Complications After Reperitonealization of Mesh at Time of Sacrocolpopexy: A Retrospective Cohort Study.

OBJECTIVES To determine if there is a difference in rates of surgical complications among patients who have reperitonealization of mesh versus no reperitonealization at time of sacrocolpopexy. METHODS This was a retrospective cohort study of all patients who underwent sacrocolpopexy at an academic medical center between 2008 and 2017. The medical record was reviewed for the operative method of sacrocolpopexy, concomitant surgeries, intraoperative or postoperative complications, and readmissions. Groups were compared on whether mesh was reperitonealized under pelvic peritoneum or not. RESULTS A total of 209 patients underwent sacrocolpopexy, with mesh reperitonealization performed in 115 (55%). Demographics were similar in both groups, except race/ethnicity and stage of prolapse. The majority (190 [91%]) of surgeries included concomitant procedures. A total of 18 intraoperative or postoperative complications (8.6%) were recorded. Relative risk of complication with mesh reperitonealization is 0.81 (95% confidence interval, 0.1-1.70). Complications for subjects without mesh reperitonealization included 4 cystostomies, 1 urethrotomy, 3 postoperative ileuses, and 1 small bowel obstruction. Among subjects with mesh reperitonealization, complications included 5 cystotomies, 2 proctotomies, 1 ureteral obstruction, and 1 small bowel obstruction. Rates of hospital readmission among both groups were not significantly different, with 3.2% of subjects without mesh reperitonealization versus 3.5% of mesh reperitonealization patients (P = 0.91) (relative risk, 1.09; 95% confidence interval, 0.38-2.56). CONCLUSIONS There is no significant difference in rates of complications or readmissions among patients with and without mesh reperitonealization at time of sacrocolpopexy. The only intraoperative complication solely attributed to mesh closure was a case with ureteral obstruction at time of reperitonealization.
Flexural Creep Behavior of High-Density Polyethylene Lumber and Wood Plastic Composite Lumber Made from Thermally Modified Wood

The use of wood plastic composite lumber as a structural member material in marine applications is challenging due to the tendency of wood plastic composites (WPCs) to creep and absorb water. A novel patent-pending WPC formulation that combines a thermally modified wood flour (as a cellulosic material) and a high strength styrenic copolymer (high impact polystyrene and styrene maleic anhydride) have been developed with advantageous viscoelastic properties (low initial creep compliance and creep rate) compared with the conventional WPCs. In this study, the creep behavior of the WPC and high-density polyethylene (HDPE) lumber in flexure was characterized and compared. Three sample groupings of WPC and HDPE lumber were subjected to three levels of creep stress; 7.5, 15, and 30% of the ultimate flexural strength (Fb) for a duration of 180 days. Because of the relatively low initial creep compliance of the WPC specimens (five times less) compared with the initial creep compliance of HDPE specimens, the creep deformation of HDPE specimens was six times higher than the creep deformation of WPC specimens at the 30% creep stress level. A Power Law model predicted that the strain (3%) to failure in the HDPE lumber would occur in 1.5 years at 30% Fb flexural stress while the predicted strain (1%) failure for the WPC lumber would occur in 150 years. The findings of this study suggest using the WPC lumber in structural application to replace the HDPE lumber in flexure attributable to the low time-dependent deformation when the applied stress value is withing the linear region of the stress-strain relationship.
Ovariectomy Activates Chronic Low‐Grade Inflammation Mediated by Memory T Cells, Which Promotes Osteoporosis in Mice

The loss of estrogen (E2) initiates a rapid phase of bone loss leading to osteoporosis in one‐half of postmenopausal women, but the mechanism is not fully understood. Here, we show for the first time how loss of E2 activates low‐grade inflammation to promote the acute phase of bone catabolic activity in ovariectomized (OVX) mice. E2 regulates the abundance of dendritic cells (DCs) that express IL‐7 and IL‐15 by inducing the Fas ligand (FasL) and apoptosis of the DC. In the absence of E2, DCs become long‐lived, leading to increased IL‐7 and IL‐15. We find that IL‐7 and IL‐15 together, but not alone, induced antigen‐independent production of IL‐17A and TNFα in a subset of memory T cells (TMEM). OVX of mice with T‐cell–specific ablation of IL15RA showed no IL‐17A and TNFα expression, and no increase in bone resorption or bone loss, confirming the role of IL‐15 in activating the TMEM and the need for inflammation. Our results provide a new mechanism by which E2 regulates the immune system, and how menopause leads to osteoporosis. The low‐grade inflammation is likely to cause or contribute to other comorbidities observed postmenopause. © 2020 American Society for Bone and Mineral Research.
Managing and preventing exacerbation of bronchiectasis.

PURPOSE OF REVIEW Pulmonary exacerbations are key events in the natural history of bronchiectasis given their impact on quality of life, prognosis, and their contribution to healthcare costs. Preventing and managing exacerbations is a priority for clinicians and in this review, we discuss measures that should be utilized to achieve this aim. RECENT FINDINGS Experts have proposed a focus on phenotyping and endotyping the bronchiectasis population to overcome the heterogeneity of this condition. Recent large studies of inhaled antibiotics and smaller studies of macrolides, which included exacerbation measures as their primary outcomes, have drawn further attention to this issue. SUMMARY Exacerbations are currently treated with prolonged antibiotic treatment (10-14 days). Prevention of exacerbations requires a multidisciplinary approach which includes optimising airway clearance and treating underlying conditions. Patients who continue to experience exacerbations despite these measures may be offered chronic macrolide therapy or additional therapies based on identified treatable traits.
Rugby game performances and weekly workload: Using of data mining process to enter in the complexity

This study aimed to i) identify key performance indicators of professional rugby matches, ii) define synthetic indicators of performance and iii) analyze how weekly workload (2WL) influences match performance throughout an entire season at different time-points (considering WL of up to 8 weeks prior to competition). This study uses abundant sports data and data mining techniques to assess player performance and to determine the influence of 2WL on performance. WL, locomotor activity and rugby specific actions were collected on 14 professional players (26.9 ± 1.9 years) during training and official matches. In order to highlight key performance indicators, a mixed-linear model was used to compare the players’ activity relatively to competition results. This analysis showed that defensive skills represent a fundamental factor of team performance. Furthermore, a principal component analysis demonstrated that 88% of locomotor activity could be highlighted by 2 dimensions including total distance, high-speed/metabolic efforts and the number of sprints and accelerations. The final purpose of this study was to analyze the influence that WL has on match performance. To verify this, 2 different statistical models were used. A threshold-based model, from data mining processes, identified the positive influence (p<0.05) that chronic body impacts has on the ability to win offensive 1 on 1 duels during competition. This study highlights practical implications necessary for developing a better understanding of rugby match performance through the use of data mining processes.
Enhanced Inflammation is a Marker for Risk of Post-Infarct Ventricular Dysfunction and Heart Failure

Acute ST-segment elevation myocardial infarction (STEMI) activates inflammation that can contribute to left ventricular systolic dysfunction (LVSD) and heart failure (HF). The objective of this study was to examine whether high-sensitivity C-reactive protein (CRP) concentration is predictive of long-term post-infarct LVSD and HF. In 204 patients with a first STEMI, CRP was measured at hospital admission, 24 h (CRP24), discharge (CRPDC), and 1 month after discharge (CRP1M). LVSD at 6 months after discharge (LVSD6M) and hospitalization for HF in long-term multi-year follow-up were prospectively evaluated. LVSD6M occurred in 17.6% of patients. HF hospitalization within a median follow-up of 5.6 years occurred in 45.7% of patients with LVSD6M vs. 4.9% without LVSD6M (p < 0.0001). Compared to patients without LVSD6M, the patients with LVSD6M had higher CRP24 and CRPDC and persistent CRP1M ≥ 2 mg/L. CRP levels were also higher in patients in whom LVSD persisted at 6 months (51% of all patients who had LVSD at discharge upon index STEMI) vs. patients in whom LVSD resolved. In multivariable analysis, CRP24 ≥ 19.67 mg/L improved the prediction of LVSD6M with an increased odds ratio of 1.47 (p < 0.01). Patients with LVSD6M who developed HF had the highest CRP during index STEMI. Elevated CRP concentration during STEMI can serve as a synergistic marker for risk of long-term LVSD and HF.
Behavior-based yield for electronic cigarette users of different strength eliquids based on natural environment topography

Abstract Introduction: The extent to which electronic cigarette users will compensate for lower nicotine eliquids has implications on the risk associated with regulating eliquid composition. This article elucidates topography as a compensatory mechanism by investigating the impact of nicotine strength on total particulate matter (TPM) and nicotine consumed per puff. Methods: Thirty-three experienced vape pen users were assigned an NJOY™ VapePen and AVAIL™ brand Tobacco Row eliquid with their usual nicotine strength (L = 6 mg/mL, M = 12 mg/mL, H = 18 mg/mL) and vaped through RIT’s wPUMTM vape pen monitor to record every puff during 1 week. Nicotine and TPM yield per puff was determined accounting for the impact of topography characteristics on emissions and used to compute participant-specific mean yield per puff. Results: Nicotine yields ranged from 0.01 to 0.05 mg/puff and varied widely within each group (L, M, and H nicotine strength). Group-wise mean flow rate was lower for L compared to M (p = 0.2) and duration was higher compared to M (p = 0.09). Larger TPM was consumed per puff for L compared to M (p = 0.07), yet nicotine per puff for L was less than M (p = 0.3). H users took smaller volumes than L (p = 0.1) or M (p = 0.17), and there was little difference between L and M (p = 0.47). Conclusions: Evidence was provided for topography as a compensatory mechanism. Use of low nicotine strength eliquids can increase TPM, which can lead to increase in HPHC. Regulatory review of new products should consider natural use topography and realistic use exposures to nicotine, TPM and HPHCs.
What We Owe to Family: The Impact of Special Obligations on Moral Judgment

Although people often recognize the moral value of impartial behavior (i.e., not favoring specific individuals), it is unclear when, if ever, people recognize the moral value of partiality. The current studies investigated whether information about special obligations to specific individuals, particularly kin, is integrated into moral judgments. In Studies 1 and 2, agents who helped a stranger were judged as more morally good and trustworthy than those who helped kin, but agents who helped a stranger, instead of kin were judged as less morally good and trustworthy than those who did the opposite. In Studies 3 and 4, agents who simply neglected a stranger were judged as less morally bad and untrustworthy than those who neglected kin. Study 4 also demonstrated that the violation (vs. fulfillment) of perceived obligations underlaid all judgment patterns. Study 5 demonstrated boundary conditions: When occupying roles requiring impartiality, agents who helped a stranger instead of kin were judged as more morally good and trustworthy than agents who did the opposite. These findings illuminate the importance of obligations in structuring moral judgment.
Scrophularia koraiensis Nakai Attenuates Allergic Airway Inflammation via Suppression of NF-κB and Enhancement of Nrf2/HO-1 Signaling

Scrophularia koraiensis Nakai (Scrophulariaceae) is a medicinal herb that grows in Korea and which has been widely used to treat fever, edema, neuritis and laryngitis. Hence, we evaluated the anti-inflammatory and antioxidant effects of the ethanol extract (SKE) of S. koraiensis Nakai in an ovalbumin (OVA)-induced mouse model. We injected 20 μg of OVA with 2 mg of aluminum on day 0 and day 14 to induce allergic airway inflammation in six-week-old BALB/c mice, and mice were challenged with 1% OVA by nebulization for 1 h on days 21, 22, and 23. SKE was orally administered at 20 mg/kg and 40 mg/kg from day 18 to 23, and its effects were compared with those of montelukast treatment. SKE significantly reduced proinflammatory cytokines, inflammatory cell counts, immunoglobulin-E, and airway hyperresponsiveness during the OVA-induced allergic airway inflammation model; it also reduced airway inflammation and mucus production. In addition, SKE reduced the OVA-induced nuclear factor kappa B (NF-κB) phosphorylation in lung tissues while enhancing nuclear factor erythroid-derived 2-related factor (Nrf-2) and heme oxygenase-1 (HO-1) expression. In conclusion, SKE showed the protective effects on OVA-induced allergic airway inflammation via the suppression of NF-κB phosphorylation and the enhancement of the Nrf2/HO-1 signaling pathway. These results indicate that SKE is a potential therapeutic agent for allergic airway inflammation.
Associations of Temperament and Character with Coping Strategies among Office Workers

Objective Coping can be defined as the reactions to harm or distress individuals take to reduce stress. This study aimed to determine how an individual’s temperament and character is correlated with the person’s main coping method. Methods The Korean version of the Ways of Coping Questionnaire and Temperament and Character Inventory-Revised-Short Version were used to evaluate the coping strategies and temperament and character of 1,035 people. Four hierarchical linear regression analyses with the scores of each coping strategy subscale as a dependent variable were performed. Results High persistence, cooperativeness, self-transcendence, and low harm avoidance were associated with using a problem-focused coping strategy. Being female, high novelty seeking, reward dependence, and self-transcendence were associated with using a support-seeking coping strategy. High novelty seeking, self-transcendence, and low self-directedness were associated with using emotion-focused coping strategy. Being female, high novelty seeking, persistence, cooperativeness, and self-transcendence were associated with using a hopeful-thinking coping strategy. Conclusion Our results show that there may be specific personality features guiding what kind of coping strategy an individual might use in a given situation.
Birthweight determines intestinal microvasculature development and alters endothelial nitric oxide synthase density in young piglets

Blood supply to enterocytes dictates intestinal health and nutrient absorption. These two aspects are impaired in low birthweight (LBW) piglets, but whether the perfusion to intestinal tissues is implicated as well is still unknown. Thus, structural changes in the microvasculature of LBW and normal birthweight (NBW) piglets were investigated during early postnatal development. Additionally, the presence of endothelial nitric oxide synthase (eNOS) in the intestinal mucosa was assessed given its important role to assure perfusion. A total of 22 pigs (11 LBW and 11 NBW) were sacrificed at days 0, 3, 8 and 19 of life. Body weight and intestinal length were recorded and a piece of the small intestine was sampled for immunohistochemical analysis of von Willebrand Factor (vWF, an endothelial cell marker) and eNOS. LBW piglets had a relatively (to body weight) longer intestine than their NBW counterparts. Age did not affect microvasculature, which was more abundant (85% larger vWF‐positive area) in NBW than LBW pigs. However, an interaction age*BW was observed for eNOS‐IR, showing that eNOS presence peaked in NBW piglets on the first day of life and subsequently decreased. This pattern was not observed in LBW piglets. The less abundant intestinal endothelial mass and the different pattern of eNOS expression observed in LBW piglets suggests microcirculation as a contributing factor in the impaired digestive functioning and gut health of LBW pigs. However, revealing whether the origin of this alteration is prenatal or postnatal, for example due to a lower milk intake, needs further study.
Crassocephalum rubens (Juss. Ex Jacq.) S. Moore improves pancreatic histology, insulin secretion, liver and kidney functions and ameliorates oxidative stress in fructose-streptozotocin induced type 2 diabetic rats

Abstract Crassocephalum rubens (C. rubens) is a traditional leafy vegetables (TLV) eaten in parts of Africa for the management of symptoms of diabetes mellitus. This study was done to investigate the in vivo anti-diabetic activity of the aqueous extract of C. rubens aerial parts (CRAQ). Type 2 diabetes (T2D) was induced in male Sprague Dawley (SD) rats by feeding them with a 10% fructose solution for two weeks followed by single dose (40 mg/kg body weight) intraperitoneal injection of streptozotocin. After confirmation of T2D, animals were treated with a low and a high dose (150 and 300 mg/kg body weight) of extract for five weeks. Parameters used as markers of hyperglycemia were analyzed in the samples collected from rats. Hematoxylin-eosin staining was used in analyzing the morphological changes of the pancreas. Treatment with high dose of the extract significantly (p < 0.05) lowered blood glucose level, increased oral glucose tolerance level and pancreatic β-cell function, while restoring the morphology of the pancreatic tissue damage. The high dose also increased insulin secretion, liver glycogen, antioxidant enzyme activities in serum and organs, and prevented liver and renal damages compared to the untreated diabetic animals. Data from this study suggest that C. rubens possesses impressive anti-diabetic activity and could be useful in ameliorating some complications associated with T2D therefore this plant can be exploited in finding new alternative therapies for the treatment of T2D.
Prehospital adenosine, lidocaine, and magnesium has inferior survival compared with tactical combat casualty care resuscitation in a porcine model of prolonged hemorrhagic shock.

To the Editor: W e read with interest the recent study of How et al. evaluating adenosine, lidocaine, and magnesium (ALM) therapy in a porcine model of prolonged hemorrhagic shock. The main finding of the study was that ALM was inferior to current Tactical Combat Casualty Care (TCCC) resuscitation in the pig model of controlled bleeding (44% to 60% blood volume loss) with mild hypothermia (36°C). This is in direct contrast to our four translational resuscitation studies from rats to pigs since 2012 showing profound benefit after controlled bleeding with up to 75% blood loss, endotoxemia, and, more recently, after noncompressible hepatic bleeding. The essence of our concern is the ALM dose used in the drip infusion, not the bolus, in the various groups. ALM at high doses is used clinically as a cardioplegia in cardiac surgery, and the low doses are used to resuscitate the heart after checking for leaks and before taking the patient off cardiopulmonary bypass. It is the low-doseALMwe have been developing for different trauma states. Despite having a cooperative research and development agreement with the Naval Medical Research Unit, San Antonio, with point person being Dr. Jacob Glaser, we were disappointed with the lack of communication and perceived reluctance of the group to share a study protocol or calculations they used to prepare the ALM solution for the different experimental groups. Through personal communication, we were advised that the ALM solution was “cloudy” andwould not dissolve.We consider this a “red flag” becausewe have never experienced this problem in our rat or pig studies at James Cook University nor at Aarhus University Hospital, Denmark.