Miracle-dz/UniFAR-FTUs huggingface dataset:
Critical Literature Review on the Definition Clarity of the Concept of Faith, Religion, and Spirituality

The critical review of the literature describes the definition clarity of spirituality, religion, and faith. These three terms are interchangeably used in the literature. However, each of these terms has its own definitions. For example, the term spirituality has more than 13 conceptual components. It is abstract and subjective and is different from religion and faith. Spirituality can be a connection to God, nature, others, and surrounding. Spirituality is associated with quality and meaning in life. Conversely, religion is attributed to traditional values and practices related to a certain group of people or faith. Religion is guided by tradition, rules, and culture. Religion is defined as a personal set or institutionalized system of religious attitudes, beliefs, and practices. Religion is the service or worship of God or the supernatural. Faith is often associated with religion and spirituality. Faith is more personal, subjective, and deeper than organized religion and relates to the relationship with God. The concept of spirituality lacks a professional understanding. It is imperative that the holistic view of nursing must strive to understand the definition of spirituality.
Molecular Epidemiology of Staphylococcus aureus in Skin and Soft Tissue Infections and Bone and Joint Infections in Korean Children

Background Community acquired-methicillin resistant Staphylococcus aureus (MRSA) clones, including ST1, ST8, and ST30 are reported worldwide. However, data among Korean children are limited. Thus, we investigated the molecular characteristics of S. aureus among children in Korea. Methods S. aureus isolated from Korean children diagnosed with skin and soft tissue infection (SSTI) or bone and joint infection due to S. aureus infection at Seoul National University Bundang Hospital, from August 2010 to November 2016, were analyzed for multilocus sequence type (ST) and SCCmec typing. Polymerase chain reaction of Panton-Valentine leukocidin (PVL), qac A/B, smr and mupA genes were also performed. Electronic medical records were reviewed for clinical data and antibiotic susceptibility results. Cases were classified into three groups: health care-associated community-onset (HACO) infections, hospital-onset (HO) infections, and community-acquired (CA) infections. Results A total of 67 strains from children with SSTI (41/67, 61.2%) and bone and joint infection (26/67, 38.8%) were included. Among all isolates, 29.9% (20/67) were MRSA, and 70% (14/20) were classified as CA, 20% (4/20) as HACO and 10% (2/20) as HO infections. MRSA rate according to disease was 34.1% (14/41) for SSTI and 23.1% (6/26) for bone and joint infection. MRSA strains included ST72-SCCmec IV (14/20, 70.0%), ST5-SCCmec II (3/20, 15.0%) and ST1-SCCmec IV (2/20, 10.0%). ST30 was the most common cause of SSTI and bone and joint infections and 96.6% (28/29) were methicillin-susceptible Staphylococcus aureus (MSSA). PVL genes were detected in 3 strains (3.8%, ST30-SCCmec IV n = 1, MSSA ST30 n = 2), qac A/B in 3 (MRSA = 3), smr in 3 (MSSA = 1, MRSA = 2) and mupA in 7 (MRSA = 5, MSSA = 2). Conclusion Molecular epidemiology of S. aureus in Korean children with SSTI and bone and joint infection showed that ST30 was predominant and mostly MSSA. Among MRSA, ST72-SCCmec type IV was the most common strain.
Calycosin ameliorates doxorubicin‐induced cardiotoxicity by suppressing oxidative stress and inflammation via the sirtuin 1–NOD‐like receptor protein 3 pathway

The limitation of doxorubicin (DOX), which is widely used for the treatment of solid tumors and hematologic malignancies, is a vital problem in clinical application. The most serious of limit factors is cardiotoxicity. Calycosin (CA), an isoflavonoid that is the major active component in Radix astragali, has been reported in many bioactivities including antitumor, anti‐inflammatory, and cardioprotection. The aim of the study was to investigate the effects and mechanisms of CA on DOX‐induced cardiotoxicity in vitro and in vivo. CA increased H9c2 cell viability and reduced apoptosis induced by DOX via Bcl‐2, Bax, and the PI3K‐Akt signaling pathway. Moreover, CA prevented DOX‐induced oxidative stress in cells by decreasing the generation of reactive oxygen species. Similarly, oxidative stress was inhibited by CA through the increased activities of antioxidant enzymes such as glutathione peroxidase, catalase, and superoxide dismutase and decreased the levels of aspartate aminotransferase, lactate dehydrogenase, and malondialdehyde in vivo. Furthermore, the levels of sirtuin 1 (Sirt1)–NOD‐like receptor protein 3 (NLRP3) and related proteins were ameliorated by CA in cells and in mice hearts. When H9c2 cells were treated by Ex527 (Sirt1 inhibitor), the effect of CA on expressions of NLRP3 and thioredoxin‐interacting protein was suppressed. In conclusion, the results suggested that CA might be a cotreatment with DOX to ameliorate cardiotoxicity by Sirt1–NLRP3 pathway.
Symptom variability over the course of the day in patients with stable COPD in Brazil: a real-world observational study

ABSTRACT Objective: To analyze symptoms at different times of day in patients with COPD. Methods: This was a multicenter, cross-sectional observational study conducted at eight centers in Brazil. We evaluated morning, daytime, and nighttime symptoms in patients with stable COPD. Results: We included 593 patients under regular treatment, of whom 309 (52.1%) were male and 92 (15.5%) were active smokers. The mean age was 67.7 years, and the mean FEV1 was 49.4% of the predicted value. In comparison with the patients who had mild or moderate symptoms, the 183 (30.8%) with severe symptoms were less physically active (p = 0.002), had greater airflow limitation (p < 0.001), had more outpatient exacerbations (p = 0.002) and more inpatient exacerbations (p = 0.043), as well as scoring worse on specific instruments. The most common morning and nighttime symptoms were dyspnea (in 45.2% and 33.1%, respectively), cough (in 37.5% and 33.3%, respectively), and wheezing (in 24.4% and 27.0%, respectively). The intensity of daytime symptoms correlated strongly with that of morning symptoms (r = 0.65, p < 0.001) and that of nighttime symptoms (r = 0.60, p < 0.001), as well as with the COPD Assessment Test score (r = 0.62; p < 0.001), although it showed only a weak correlation with FEV1 (r = −0.205; p < 0.001). Conclusions: Dyspnea was more common in the morning than at night. Having morning or nighttime symptoms was associated with greater daytime symptom severity. Symptom intensity was strongly associated with poor quality of life and with the frequency of exacerbations, although it was weakly associated with airflow limitation.
High Prevalence of Intraductal Papillary Mucinous Neoplasms in Type 2 Diabetes Mellitus Patients.

DISCUSSION Our results have first shown no difference in terms of sex distribution neither for AP nor for CP hospitalizations. For AP, such results support the statement that an equal proportion of men and women develop AP. However, for CP, we are not able to support the statement that a greater number of men develop CP compared with women. Our results have also shown that the mean age at hospitalization was significantly higher for AP than for CP. This observation is inconsistent with what is found in the literature because AP usually occurs before CP in a possible continuum. Taken together, these contradictory results could be explained by the fact that the number of CP cases could be underestimated because the criteria for CP diagnosis are still unclear, especially in the early stages. Similar to the results obtained in a recent meta-analysis, our study has shown that an important proportion (~20%) of patients has suffered from RAP. Of them, nearly 3% were hospitalized 5 times and over with a larger proportion of men. It is well known that the accumulation of pancreatitis episodes considerably increases the risk of developing CP. Preventing RAP development by identifying the etiology of the first AP episode and avoiding the cause is mandatory to reduce CP incidence. In conclusion, because there is no prospective cohort study devoted to pancreatitis disease in the SLSJ population, our study is so far the most accurate estimate frequencies of AP, RAP, and CP. Nonetheless, the use of health administrative data may result in an underestimated prevalence of AP and CP cases in the SLSJ population, as it occurs in many other chronic conditions. This can be explained by the fact that some individuals come to the emergency room without being admitted to the hospital. Nevertheless, this study emphasizes the need to identify risk markers of RAP and CP that would help reduce the individual and social burden related to pancreatitis disease in the SLSJ region or elsewhere.
Immunohistochemical Markers With Potential Diagnostic, Prognostic, and Therapeutic Significance in Uterine Carcinosarcoma: A Clinicopathologic Study of 43 Cases

Uterine carcinosarcomas (UCS) are rare and highly aggressive tumors. Although it is currently accepted that the majority of UCS are metaplastic carcinomas, their aggressive behavior is unparalleled to that of any other high-grade endometrial neoplasms. Therefore, the search for the distinct immunohistochemical and molecular features that could help in the development of new treatment strategies continues. We evaluated the expression of PDL-1, growth hormone releasing hormone receptor, p53, WT1, PAX-8, estrogen receptor, HNF-1, and mismatch repair proteins in 43 UCS. Tumors were selected from the archives of the Magee-Womens Hospital University of Pittsburgh Medical Center Department of Pathology. Seventeen were stage I, 4 were stage II, 15 were stage III, and 7 were stage IV. The median age was 67 yr and median overall survival was 3.2 yr. Immunostaining for PAX8, HNF-1, and estrogen receptor showed statistically significant difference between epithelial and stromal components. Expression of p53 was significantly associated with clinical high stage, but other markers did not correlate with stage or survival. Immunostaining for programmed death ligand-1 was strongly positive in 30 UCS (70%), including 24 cases with tumor cell positivity, 12 cases with tumor cell and tumor-infiltrating immune cell positivity, and 6 cases with tumor-infiltrating immune cell positivity only. Of 27 tumors tested for mismatch repair expression, 12 (44%) showed loss of expression, 7 of which were PDL-1 positive. Growth hormone releasing hormone receptor was positive in 38 tumors (88%) and predominantly expressed in the epithelial component. The range of positivity for programmed death ligand-1 and growth hormone releasing hormone receptor suggests a possible potential adjuvant treatment that may be considered for UCS.
Enhancing stability by penetrating the apophysis of greater trochanter or the posterior neck cortex during titanium elastic nailing of paediatric subtrochanteric femoral fractures in children aged 5–12 years

We modified the traditional titanium elastic nail (TEN) technique to increase stability, by involving the apophysis of the greater trochanter (GT) and the femoral neck cortex. We report the clinical/radiological outcomes after at least 5 years of follow-up. We prospectively included 17 children aged 5–12 years diagnosed with subtrochanteric femoral fractures between January 2004 and December 2013. Radiological evaluations of bony union, malunion, and limb-length discrepancies (LLDs) were performed at the final follow-up. Clinical outcomes, as revealed by the Flynn scoring system, and the range of hip motion were also recorded. The mean patient age was 8.4 ± 2.0 years. Twelve patients presented with length-stable fractures and the others with unstable fractures. Bony union was evident at a mean of 4.5 months postoperatively. Radiologically, malunion >5° was evident in three patients, but all angles were <10° at the final follow-up. LLDs >1 cm were evident in five patients, but all were <2 cm at the final follow-up. Thirteen patients showed excellent outcomes and 4 had satisfactory outcomes. Complications were apparent in only two patients; both showed only temporary discomfort caused by prominent nails. The range of hip motion was satisfactory in all cases; no difference compared to the contralateral hip was apparent. Finally, the radiological/clinical outcomes did not differ by the fracture stability or pattern. We penetrated the apophysis of the GT and the femoral neck cortex with TENs to further stabilise subtrochanteric femoral fractures. This was a simple procedure that enhanced patient outcomes. Level of evidence: therapeutic level II.
Comparison of the performance of machine learning algorithms in breast cancer screening and detection: A protocol

Background: Breast Cancer (BC) is a known global crisis. The World Health Organization reports a global 2.09 million incidences and 627,000 deaths in 2018 relating to BC. The traditional BC screening method in developed countries is mammography, whilst developing countries employ breast self-examination and clinical breast examination. The prominent gold standard for BC detection is triple assessment: i) clinical examination, ii) mammography and/or ultrasonography; and iii) Fine Needle Aspirate Cytology. However, the introduction of cheaper, efficient and noninvasive methods of BC screening and detection would be beneficial. Design and methods: We propose the use of eight machine learning algorithms: i) Logistic Regression; ii) Support Vector Machine; iii) K-Nearest Neighbors; iv) Decision Tree; v) Random Forest; vi) Adaptive Boosting; vii) Gradient Boosting; viii) eXtreme Gradient Boosting, and blood test results using BC Coimbra Dataset (BCCD) from University of California Irvine online database to create models for BC prediction. To ensure the models’ robustness, we will employ: i) Stratified k-fold Cross- Validation; ii) Correlation-based Feature Selection (CFS); and iii) parameter tuning. The models will be validated on validation and test sets of BCCD for full features and reduced features. Feature reduction has an impact on algorithm performance. Seven metrics will be used for model evaluation, including accuracy. Expected impact of the study for public health: The CFS together with highest performing model(s) can serve to identify important specific blood tests that point towards BC, which may serve as an important BC biomarker. Highest performing model(s) may eventually be used to create an Artificial Intelligence tool to assist clinicians in BC screening and detection. Significance for public health This study could potentially identify important Breast Cancer (BC) biomarkers based on patients’ routine anthropometric blood data. This will be attempted using correlation-based feature selection algorithm, together with highest performing machine learning model(s) from this study, and publicly available BC Coimbra Dataset from University of California Irvine database. The biomarkers may provide direction for clinicians to explore in future BC clinical trials. Trials will serve to validate biomarkers from this study and could be introduced in clinical settings globally as an easy, cost-effective first step for BC screening and detection. An Artificial Intelligence tool can eventually be created using highest performing model(s). Clinicians can input patient-specific biomarkers into the tool. The tool would output the likelihood of patients having BC, with a certain level of accuracy. This envisioned process could serve to eventually revolutionize the early prediction of BC in patients and consequently, a reduction in BC mortality rate.
Limited diagnostic accuracy and clinical impact of single-operator peroral cholangioscopy for indeterminate biliary strictures

Abstract Background Single-operator peroral cholangioscopy (sPOCS) is considered a valuable diagnostic modality for indeterminate biliary strictures. Nevertheless, studies show large variation in its characteristics and measures of diagnostic accuracy. Our aim was to estimate the diagnostic accuracy of sPOCS visual assessment and targeted biopsies for indeterminate biliary strictures. Additional aims were: estimation of the clinical impact of sPOCS and comparison of diagnostic accuracy with brush cytology. Methods A retrospective single-center study of adult patients who underwent sPOCS for indeterminate biliary strictures was performed. Diagnostic accuracy was defined as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The clinical impact of sPOCS was assessed by review of medical records, and classified according to its influence on patient management. Results 80 patients were included, with 40 % having primary sclerosing cholangitis (PSC). Prior ERCP was performed in 88 %, with removal of a biliary stent prior to sPOCS in 55 %. The sensitivity, specificity, PPV, and NPV for sPOCS visual impression and targeted biopsies were 64 %, 62 %, 41 %, and 84 %, and 15 %, 65 %, 75 %, and 69 %, respectively. The clinical impact of sPOCS was limited; outcome changed management in 17 % of patients. Sequential brush cytology sensitivity, specificity, PPV, and NPV were 47 %, 95 %, 80 %, and 83 %. Conclusions The diagnostic accuracy of sPOCS for indeterminate biliary strictures was found to be inferior to brush cytology, with a low impact on patient management. These findings are obtained from a select patient population with a high prevalence of PSC and plastic stents in situ prior to sPOCS.
Impact of a Progressive Mobility Program on the Functional Status, Respiratory and Muscular Systems of ICU Patients: A Randomized and Controlled Trial.

OBJECTIVES The aim was to investigate whether patients who participated in a mobility program in the ICU performed better on functional status, muscle, mobility, and respiratory assessments upon discharge than patients who received conventional physiotherapy. DESIGN Randomized controlled trial. SETTING Blind evaluation. PATIENTS Adults with previous functional independence and without contraindications for mobilization were eligible. INTERVENTIONS The intervention group participated in an early and progressive mobility program with five levels of activity. The control group underwent the conventional treatment without a preestablished routine. We evaluated functional status, level of activity, respiratory status, muscle strength, and mobility at ICU discharge. MEASUREMENTS AND MAIN RESULTS We analyzed 49 patients in the control group and 50 patients in the intervention group. Our data showed patients with better functional status and more functionally independent patients in the intervention group compared with those in the control group (96% vs 44%; p < 0.001). The results of the sit-to-stand and 2-minute walk tests, as well as the results of the maximum voluntary ventilation tests, also varied between the groups. The intervention group had shorter ICU stays than the control group. Higher Barthel index scores were associated with the amount of activity and participation in the protocol. The benefits to functional status remained during follow-up. CONCLUSIONS Patients who participated in an ICU mobility program had better functional status at discharge from the ICU. The other benefits of the program included better performance in the mobility tests and improved maximum voluntary ventilation performance.
The Varying Effects of the Food, Built, and Socioeconomic Environment on BMI

Although federal, state, and local health authorities have invested substantively in a diverse range of interventions to combat the obesity epidemic during the past decade (1-3), the original expectation of achieving a modest decline in this condition’s prevalence, as measured by BMI, has not been fully realized. According to the National Health and Nutrition Examination Survey 2015-2016, the prevalence of obesity among US adults and youth was still 39.8% and 18.5%, respectively (4). Although this development does not necessarily suggest a global failure in public health’s response to this epidemic, it does warrant some introspection and review of the approaches being taken to address this public health threat. For example, lingering questions remain: Are policies implemented to improve the quality of food environments effective and adequately supported by evidence? Do the mixed results commonly seen with built environment interventions suggest a poor return on investment for these types of upstream interventions (or is it just simply too early to tell)? How influential is socioeconomic status on health behaviors such as physical activity and sedentary lifestyles?
Self-controlled amount and pacing of practice facilitate learning of a sequential timing task

ABSTRACT Allowing learners to control the number of practice trials has been shown to facilitate motor learning (Lessa & Chiviacowsky, 2015; Post et al., 2011; 2014). However, it is uncertain the extent to which prior findings were influenced by the combined effects of allowing participants to control both the pacing- and amount-of-practice. The present study examined the independent effects of self-controlled amount- and pacing-of-practice on learning a sequential timing task. Participants were assigned to a self-controlled-amount-of-practice (SCA), self-controlled-pacing-of-practice (SCP), yoked-amount-of-practice (YKA), or a yoked-pacing-of-practice (YKP) group. Participants completed acquisition, immediate retention/transfer and delayed retention/transfer. During acquisition, SCA controlled the number of acquisition blocks completed with a fixed inter-trial interval while SCP controlled the inter-trial interval with a fixed number of blocks. Yoked groups were matched to a self-control counterpart so the amount (YKA) and pacing (YKP) were equivalent. Self-control groups demonstrated lower absolute constant error during immediate-retention and lower absolute constant error and variable error during delayed retention (p < .05). For intrinsic motivation, SCA scored significantly higher than SCP for the subscale Interest/Enjoyment (p < .05). Findings indicated that self-control, regardless of type, facilitated motor learning. Further work is needed to continue to examine the relationship between controlling the amount and pacing of practice on skill acquisition.