Miracle-dz/UniFAR-FTUs huggingface dataset:
Comparison analysis of PD-1/PD-L1 inhibitors plus lenvatinib or gemcitabine/cisplatin as first-line treatment for patients with advanced intrahepatic cholangiocarcinoma

Background Intrahepatic cholangiocarcinoma (ICC) is a highly aggressive primary liver cancer, with increasing incidence worldwide. Effective first-line treatments for advanced ICC patients are currently limited. Therefore, our study aimed to assess the efficacy and safety of programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) inhibitors in combination with gemcitabine/cisplatin (GC) and lenvatinib as first-line treatment in advanced ICC patients. Methods This retrospective cohort study included 51 advanced ICC patients, among whom 25 patients were administered with PD-1/PD-L1 plus lenvatinib and 26 patients were administered with PD-1/PD-L1 plus GC. Baseline characteristics including demographic information, medical history, clinical characteristics, laboratory data, and imaging examination were collected. The primary endpoints were progression-free survival (PFS) and sixth- and ninth-month overall survival (OS) rate. Survival curve was plotted by the Kaplan–Meier method. A Cox proportion risk model was performed to investigate independent risk factors of PFS and OS. The secondary outcomes were objective response rate (ORR), disease control rate (DCR), and adverse events. Results The median age of advanced ICC patients in our study was 58.0 (95% confidence interval [95% CI] = 48.0–72.4) years, with 33 male and 18 female patients. Patients in the PD-1/PD-L1 inhibitors plus lenvatinib group were more likely to be in ECOG grade above 1, develop ascites, and have an elevated level of ALT. The ORR was 16.0% in the PD-1/PD-L1 inhibitors plus lenvatinib group and 23.1% in the GC group (p = 0.777). The DCR was 52.0% in the lenvatinib group and 46.2% in the GC group (p = 0.676). The combination treatment of PD-1/PD-L1 inhibitors plus lenvatinib was associated with longer PFS than the GC group; however, it was not statistically significant (lenvatinib: 9.5 months, GC: 5.1 months, p = 0.454). The sixth-month and ninth-month OS rates were 82.0% and 76.9% in the lenvatinib group and 87.4% and 71.5% in the GC group. After adjusting for confounders, multivariate Cox regression analysis showed that ECOG grade above 1 was an independent risk factor for PFS (hazard ratio [HR] = 3.388, 95% CI = 1.312–8.746, p = 0.012) and OS (HR = 4.220, 95% CI = 1.131–15.742, p = 0.032). Conclusion PD-1/PD-L1 inhibitors in combination with lenvatinib or GC all demonstrated significant efficacy and safety as first-line treatment in patients with advanced ICC. As for patients who refuse or are intolerant to chemotherapy, PD-1/PD-L1 plus lenvatinib would be recommended.
Effect of caudal nalbuphine on postoperative emergence agitation in pediatrics undergoing infra-umbilical surgeries: Randomized double-blind study

ABSTRACT Background Postoperative agitation is characterized by increased recovery time, irritability, and disorientation. This study hypothesized that adding nalbuphine to caudal bupivacaine could improve postoperative emergence agitation (EA). Methods Eighty children (2-12 years and ASA I-II) undergoing sub-umbilical abdominal surgeries were randomly allocated into two equal groups. Group-B received caudal bupivacaine 0.125 of 1 ml/kg plus 2 ml normal saline, whereas Group-N received caudal bupivacaine 0.125 of 1 ml/kg plus 0.2 mg/kg nalbuphine diluted in 2ml normal saline. We evaluated postoperative EA according to the pediatric anesthesia emergence delirium scale (PAED) on admission to the PACU and every 30 minutes for two hours postoperatively. Postoperative pain, sedation, rescue analgesia complications, and parents’ satisfaction were also recorded. Results No statistically significant difference between both groups regarding the postoperative PAED scale at different times (p > 0.05), but inside each group, there was a significant decrease PAED scale at different times of assessment (p < 0.001) as compared to baseline data. Group-N had significantly better results concerning postoperative sedation and analgesia. No significant differences between study groups as regardingthe hemodynamic parameters. Group-N had a significantly prolonged time to 1st analgesic request, lower total rescue analgesia consumption, and more parents’ satisfaction scores. No serious adverse effects were recorded during the study. Conclusion Adding nalbuphine to bupivacaine during pediatric caudal block had no significantly different effects on postoperative EA (PAED score). Both drugs decreased the incidence of EA with less severity in the nalbuphine group. Nalbuphine also decreases postoperative pain with more sedation.
SOIL FERTILITY & PLANT NUTRITION Assessment of Plant-Available Potassium for No- Till, Rainfed Soybean

Temporal and spatial availability of K can influence soybean [Glycine max (L.) Merr. ] productivity. This study quantified the impact of initial soil K concentrations, soil-water content, and soybean K uptake on soil K pools (water-extractable solution-phase K [K sol ], 1 mol L -1 NH 4 OAc-extractable K, referred to as exchangeable K (K exch ), and 5-min sodium tetraphenylboron [NaTPB] extractable K [K TPB ]) and compared predictions of plant K availability using the NaTPB vs. NH 4 OAc tests. Soil and soybean samples were collected five times between the VE and R6 development stages in 2003 and 2004 from fallow and cropped no-till Toronto-Millbrook silt loam Alfisols at the Throckmorton Purdue Agricultural Center. Gravimetric soil water content was measured weekly during the growing season. Low-, medium-, and high-K fertility plots were replicated four times. Initial K exch levels ranged from 60 to 290 and from 50 to 90 mg kg -1 at the 0- to 10- and 10- to 20-cm depths, respectively. Medium- and high-fertility soils had the highest grain yields. The 0- to 5-cm soil layer had the highest K exch levels, water availability, and soybean K uptake. Compared with K exch K sol levels were less stratified and the surface layer was less dynamic. The NaTPB extraction was a better predictor of soybean K uptake in 1 yr, but across both years, NH 4 OAc was superior. Potassium measurements in the 0- to 10-cm soil layer provided slightly better estimates of plant K uptake than those in the 0- to 20-cm layer. Greater water availability and K uptake in the 0- to 5-cm soil layer suggest that under evenly distributed, intermittent rainfall conditions in somewhat poorly drained soils, vertical soil K stratification might not be a concern for no-till soybean production.
Estructura productiva y desigualdad regional: La transición hacia el euro y la economía del conocimiento

This article analysesthe trend in regional convergence in Spain over the period 1986-1998, using Fundacion BBVA and Regional Accounting statistical information. We show that the meagre advances observed in the reduction of regional dispersion correspond to closer matching of regional productivity levels, which is the outcome of an intense process of harmonisation of productive structures. Productivity convergence, however, seems to have practicallyreached its culminating point given the existing patterns of localisation of the most knowledge-intensive economic activities and the persistence of interregional sectoral productivity differentials.
Farmers' Livelihoods and Biodiversity Conservation in a Coffee Landscape of El Salvador

The production and commercialization of coffee is important to both the environment and the economic development of producing countries (Rice and Ward 1996). Recently, the coffee commodity has suffered from an international price crisis, which has called attention to the high level of environmental and economic vulnerability affecting farmers and landscapes (Ponte 2002; Rice 2001). This chapter examines a particular interface between agriculture, rural development and biodiversity conservation in a coffee landscape of El Salvador during the time of the coffee crisis. The general objective was to gain a better understanding of the socio-ecological relationships associated with “biodiversity friendly” coffee plantation management in three different small-scale farmer cooperatives. The research also analyzed the interactions between different types of cooperatives, shade-tree management and household livelihoods. Parallel to the objectives exclusively relating to research, an action-research process was initiated between the three cooperatives and the researchers involved. This resulted in a solid partnership and the formation of a permanent, non-profi t foundation that conducts research and supports local development at the site. This chapter presents both the results of research conducted between 1999 and 2004, as well as refl ections on the outcomes of the action-research process to date.
Uncoupled and coupled solutions of volume change problems in expansive soils

Lightly loaded structures constructed on expansive soils are often subjected to severe distress subsequent to construction, as a result of changes in the pore-water pressures in the soil. The structures most commonly damaged are roadways, airport runways, small buildings, irrigation canals, spillway structures and all near ground surface structures associated with infrastructure development. Changes in the pore-water pressure can occur as a result of variations in climate, change in depth to the water table, water uptake by vegetation, removal ofvegetation or the excessive watering of a lawn. An analytical tool for the prediction of heave is extremely valuable to geotechnical engineers. There has been little advancement in the development of such a tool for solving engineering problems. There does not appear to be a computer program that has been written and widely accepted for solving this problem. It is important that such an analytical tool be developed and that it be developed for both oneand two-dimensional problems. The primary objective of this research study is to apply the general theory of consolidation/swelling for unsaturated soils to provide a reliable, practical technique for the prediction of one-, twoor three-dimensional volume change associated with unsaturated, expansive soils. The void ratio constitutive surface of an unsaturated, expansive soil was estimated from volume change indices obtained from conventional oedometer tests. Mathematical equations, which can be applied over a wide range of stress conditions, are proposed to describe the constitutive surfaces for both soil structure and water phase. The elastic parameter functions that are required for the volume change analysis are calculated from the constitutive surfaces with an assumed value ofPoisson's ratio. The solutions to the volume change problems associated with an unsaturated, expansive soil are obtained using both an uncoupled and a coupled approach. In the uncoupled approach, the continuity equation for the water phase and the equilibrium equations are solved independently. Uncoupled solutions are obtained using a partial differential equation solver, called FlexPDE. In the coupled approach, the continuity equation and the equilibrium equations are solved simultaneously. Coupled solutions are obtained using a finite element program, called COUPSO. The examples presented in this study represent typical volume change problems that are often encountered in engineering practice (i.e., influence of vegetation on light engineering structures, water leakage under floor slab,
Risk factors of preterm birth in Sri Lanka: case-control study

Introduction: Preterm birth is a major challenge as a contributor to neonatal and child mortality in low- and middle-income countries (LMIC). Many countries toil to prevent and care for preterm babies. Country-specific solid data on risk factors of preterm births are crucial to formulate preventive strategies. Objectives: To determine the antenatal risk factors of preterm births in Sri Lanka Methods: An unmatched case-control study was conducted in seven Government hospitals with obstetric and neonatal care facilities in Colombo District in Sri Lanka. Live-born, spontaneous or provider-initiated, 374 preterm babies (<37 & >24 weeks of gestation) as cases and live-born 374 term babies as controls were recruited from mothers who had a dating scan before 22 weeks. A risk factor profile worked out by extensive literature search and consultation of experts was subjected to multivariable analysis to identify risk factors. Results: Risk factors identified were: multiple pregnancy (adjusted odds ratio (aOR)=10.57; 95% CI: 3.48, 32.08); bleeding/spotting during pregnancy (aOR=3.51; 95% CI: 1.77, 6.98), past preterm birth (aOR= 2.83; 95% CI: 1.09, 7.36), recent stressful life event (aOR=2.62; 95% CI: 1.43, 4.81), higher gravidity (aOR=2.58; 95% CI: 1.35, 4.9), dissatisfaction with self-assessed own health (aOR=2.54; 95% CI: 1.52, 4.22), pregnancy induced hypertension (aOR=2.25; 95% CI: 1.16, 4.38), no antenatal dental assessment (aOR=2.16; 95% CI: 1.23, 3.81), unsatisfactory oral hygiene (aOR=2.01; 95% CI: 1.33, 3.04), long standing hours during 3rd trimester (aOR=1.91; 95% CI: 1.24, 2.94) and cooking using firewood (aOR=1.51; 95% CI: 1.01, 2.25). Sexual abstinence (aOR=0.46; 95% CI: 0.26, 0.81) was a protective factor. Conclusions & Recommendations: Modifiable and unmodifiable factors for preterm births were identified. Special care during pregnancy and early admission is recommended for multiple pregnancy, those had spotting during pregnancy and those had past preterm delivery. Avoiding stress during pregnancy and emphasizing oral hygiene are recommended.
Improved Characterization of Circulating Tumor Cells and Cancer-Associated Fibroblasts in One-Tube Assay in Breast Cancer Patients Using Imaging Flow Cytometry

Simple Summary Liquid biopsy is a promising but challenging tool for potentially upgrading cancer patient diagnostics and providing new insights into tumor biology. Here, we applied a unique approach to detect CTCs and cCAFs in a one-tube assay using imaging flow cytometry, enabling improved enumeration, multimarker-based phenotyping, and detailed morphological characterization of those rare cells. We identified new, putatively EMT-related phenotypes of negative CTCs for both epithelial and mesenchymal markers and showed that EMT-related CTCs might contribute to breast cancer progression, whereas a coincidence of CTCs and cCAFs might be a signature of metastasis. Abstract Circulating tumor cells (CTCs) and circulating cancer-associated fibroblasts (cCAFs) have been individually considered strong indicators of cancer progression. However, technical limitations have prevented their simultaneous analysis in the context of CTC phenotypes different from epithelial. This study aimed to analyze CTCs and cCAFs simultaneously in the peripheral blood of 210 breast cancer patients using DAPI/pan-keratin (K)/vimentin (V)/alpha-SMA/CD29/CD45/CD31 immunofluorescent staining and novel technology—imaging flow cytometry (imFC). Single and clustered CTCs of different sizes and phenotypes (i.e., epithelial phenotype K+/V− and epithelial–mesenchymal transition (EMT)-related CTCs, such as K+/V+, K−/V+, and K−/V−) were detected in 27.6% of the samples and correlated with metastases. EMT-related CTCs interacted more frequently with normal cells and tended to occur in patients with tumors progressing during therapy, while cCAFs coincided with CTCs (mainly K+/V− and K−/V−) in seven (3.3%) patients and seemed to correlate with the presence of metastases, particularly visceral ones. This study emphasizes the advantages of imFC in the field of liquid biopsy and highlights the importance of multimarker-based analysis of different subpopulations and phenotypes of cancer progression-related cells, i.e., CTCs and cCAFs. The co-detection of CTCs and cCAFs might improve the identification of patients at higher risk of progression and their monitoring during therapy.
A Hybrid Ultrasonic Membrane Anaerobic System (UMAS) Development for Palm Oil Mill Effluent (POME) Treatment

The high chemical oxygen demand (COD) and biochemical oxygen demand (BOD) levels in palm oil mill effluent (POME) wastewater make it an environmental contaminant. Moreover, conventional POME wastewater treatment approaches pose economic and environmental risks. The present study employed an ultrasonic membrane anaerobic system (UMAS) to treat POME. Resultantly, six steady states were procured when a kinetic assessment involving 11,800–21,700 mg·L−1 of mixed liquor suspended solids (MLSS) and 9800–16,800 mg·L−1 of mixed liquor volatile suspended solids (MLVSS) was conducted. The POME treatment kinetics were explained with kinetic equations derived by Monod, Contois and Chen and Hashimoto for organic at loading rates within the 1–11 kg·COD·m−3·d−1 range. The UMAS proposed successfully removed 96.6–98.4% COD with a 7.5 day hydraulic retention time. The Y value was 0.67 g·VSS/g·COD, while the specific micro-organism decay rate, b was 0.24 day−1. Methane (CH4) gas production ranged from 0.24 to 0.59 litres per gram of COD daily. Once the initial steady state was achieved, the incoming COD concentrations increased to 88,100 mg·L−1. The three kinetic models recorded a minimum calculated solids retention time of 12.1 days with maximum substrate utilization rate, K values ranging from 0.340 to 0.527 COD·g−1·VSS·d−1 and maximum specific growth rate, µmax from 0.248 to 0.474 d−1. Furthermore, the solids retention time (SRT) was reduced from 500 to 12.1 days, resulting in a 98.4% COD level reduction to 1400 mg·L−1.
Causes and Implications The Recent Increase in Atlantic Hurricane Activity

www.sciencemag. org (this information is current as of July 9, 2009 ): The following resources related to this article are available online at http://www.sciencemag. org/cgi/content/full/sci;293/5537/1997 A correction has been published for this article at: http://www.sciencemag. org/cgi/content/full/293/5529/474 version of this article at: including high-resolution figures, can be found in the online Updated information and services, http://www.sciencemag. org/cgi/content/full/293/5529/474/DC1 can be found at: Supporting Online Material found at: can be related to this article A list of selected additional articles on the Science Web sites http://www.sciencemag. org/cgi/content/full/293/5529/474#related-content http://www.sciencemag. org/cgi/content/full/293/5529/474#otherarticles , 1 of which can be accessed for free: cites 31 articles This article 281 article(s) on the ISI Web of Science. cited by This article has been http://www.sciencemag. org/cgi/content/full/293/5529/474#otherarticles 18 articles hosted by HighWire Press; see: cited by This article has been http://www.sciencemag. org/cgi/collection/atmos Atmospheric Science : subject collections This article appears in the following
The Impact of a Weekend Dance Program on Social-Emotional Learning Among Young Children

Dance and movement encourages socialization promoting children's social and emotional skills. This study aimed to examine the impact on the SEL of children after a weekend dance program. METHOD: This study employed a quasi-experimental controlled trial design with 60 children aged 5-6 in Fujian Province, China. Participants were randomly assigned to either an integrated dance program group (n=30) or control group (n=30). The weekend dance program was led by professional instructors and consisted of 12 weekly lessons, each lasting 50 minutes. Pre- and post-measurements were taken using the Social-Emotional and Character Development Scale (SECDS) and the Preschooler Gross Motor Quality Scale (PGMQS) to assess changes in social-emotional learning and gross motor skills. Repeated-measures ANOVA tests were conducted to determine the impact of the integrated dance program.RESULTS: The study found a significant difference in the changes between the two groups, indicating that the weekend dance program had a positive impact on the social-emotional behavior and motor skill quality of the children who participated compared to the control group. Specifically, the participants in the dance program group demonstrated significantly greater improvements in their social-emotional behavior and motor skill quality compared to those in the control group.CONCLUSION: The study provides preliminary evidence that an integrated dance program can promote social-emotional development and gross motor skills in young children. After-school dance activities may help to improve children's well-being. Further research is needed to understand the underlying mechanisms and to evaluate alternative arts-based therapies.
ROLE OF SERUM CHOLESTEROL AND ALBUMIN LEVELS AS A RISK FACTOR FOR DEVELOPING SURGICAL SITE INFECTION

Background: Surgical site infection (SSI) causes significant morbidity and mortality in addition to lengthier hospital stays and higher healthcare expenses. The risk of SSIs can be significantly influenced by a number of patient-related factors (old age, nutritional status, pre-existing infection, and comorbid illness). The present study is thus designed to determine the role of serum cholesterol and serum albumin levels as a risk factor for developing surgical site infection following elective surgery. Materials and Methods: A prospective cohort study including 200 patients undergoing elective surgery was conducted at a tertiary healthcare center. The preoperative S. Albumin, S. Cholesterol, length of hospital stay, duration of surgery was considered for this study and its relation to surgical site infection was obtained. Data was analyzed using SPSS software ver. 21.0. Result: Out of the total 200 cases, SSI was observed in 54 cases (27%). Mean albumin levels were significantly lower in cases with SSI (p<0.01). However, mean cholesterol levels were comparable in cases with and without SSI (p-0.94). Mean hospital stay was significantly higher in cases who developed SSI (p<0.01). Conclusion: Observations made in the present study showed that pre-operative albumin level is a good prognostic indicator for predicting the development of surgical site infections after surgery. However, no significant association was observed with respect to cholesterol levels. We thus conclude that serum albumin level is a significant predictor for development of surgical site infections and should be done in all cases prior to surgery.
Dynamical correlation functions from complex time evolution

We present an approach to tame the growth of entanglement during time evolution by tensor network methods. It combines time evolution in the complex plane with a perturbative and controlled reconstruction of correlation functions on the real-time axis. We benchmark our approach on the single impurity Anderson model. Compared to purely real-time evolution, the complex time evolution significantly reduces the required bond dimension to obtain the spectral function. Notably, our approach yields self-energy results with high precision at low frequencies, comparable to numerical renormalization group (NRG) results, and it successfully captures the exponentially small Kondo energy scale.