Miracle-dz/UniFAR-FTUs huggingface dataset:
End of life communication among caregivers of children with cancer: A qualitative approach to understanding support desired by families

Abstract Objectives Clinicians and parents are encouraged to have open and honest communication about end of life with children with cancer, yet there remains limited research in this area. We examined family communication and preferred forms of support among bereaved caregivers of children with cancer. Methods Bereaved caregivers were recruited through a closed social media group to complete an online survey providing retrospective reports of end of life communication with their child and preferences for communication support from health-care providers. The sample of 131 participants was mostly female (77.9%; n = 102) with an average age of 49.15 (SD = 8.03) years. Deceased children were of an average age of 12.42 years (SD = 6.01) and nearly 90% of children died within 5 years of diagnosis. Results Most caregivers spoke with their child about their prognosis (61.8%; n = 131) and death (66.7%; n = 99). Half of children (48%; n = 125) asked about death, particularly older children (51.9% ≥12 years; p = 0.03). Asking about dying was related to having conversations about prognosis (p ≤ 0.001) and death (p ≤ 0.001). Most caregivers (71.8%; n = 94) wanted support to talk to their children. Fewer wanted providers to speak to children directly (12.2%; n = 16) or to be present while caregivers spoke to the child (19.8%; n = 26). Several themes emerged from a content analysis of open-ended responses regarding preferences for provider support. Significance of results Most caregivers discussed issues pertaining to end of life irrespective of demographic or medical factors. Qualitative themes provide insight into support desired by families to help with these difficult conversations.
Prevalence of processed and ultra-processed food intake in Brazilian children (6–24 months) is associated with maternal consumption and breastfeeding practices

Abstract The aim of this study is to identify maternal consumption of processed and ultra-processed foods and to verify the factors associated with the supply of these foods to Brazilian children. This is a cross-sectional study with 231 mothers and children aged from 6 to 24 months. The mother’s and children's food consumption was measured using three 24-hour recalls. The foods consumed were categorised according to the NOVA classification. The data were analysed by multinomial logistic regression. The supply of processed and ultra-processed foods to children was associated with the child’s age (T2: OR = 1.17, p<.001; T3: OR = 1.23, p<.001), the absence of breast milk consumption (T3: OR = 3.82, p=.006) and the greater consumption of these foods by mothers (T2: OR = 3.15, p=.018; T3: OR = 4.59, p=.004). We conclude that mothers who consume processed and ultra-processed foods also include them in complementary feeding, and the consumption of these foods by the child increases with age, absence of breastfeeding, and with increased maternal consumption.
Complexity of desire for hastened death in terminally ill cancer patients: A cluster analysis

Abstract Objectives The present study aims were (1) to identify the proportion of terminally ill cancer patients with desire for hastened death (DHD) receiving specialized palliative care, (2) to identify the reasons for DHD, and (3) to classify patients with DHD into some interpretable subgroups. Methods Advanced cancer patients admitted to 23 inpatients hospices/palliative care units in 2017 were enrolled. Data were prospectively obtained by the primarily responsible physicians. The presence/absence of DHD and reasons for DHD were recorded. A cluster analysis was performed to identify patterns of subgroups in patients with DHD. Results Data from 971 patients, whose Richmond Agitation–Sedation Scale score at admission was zero and who died in palliative care units, were analyzed. The average age was 72 years, common primary cancer sites were the gastrointestinal tract (31%) and the liver/biliary ducts/pancreas (19%). A total of 174 patients (18%: 95% confidence interval, 16–20) expressed DHD. Common reasons for DHD were dependency (45%), burden to others (28%), meaninglessness (24%), and inability to engage in pleasant activities (24%). We identified five clusters of patients with DHD: cluster 1 (35%, 61/173): “physical distress,” cluster 2 (21%, 37/173): “dependent and burdensome,” cluster 3 (19%, 33/173): “hopelessness,” cluster 4 (17%, 30/173): “profound fatigue,” and cluster 5 (7%, 12/173): “extensive existential suffering. ” Conclusions A considerable number of patients expressed DHD and could be categorized into five subgroups. These findings may contribute to the development of therapeutic strategies.
Acid-catalysed intramolecular cyclization of geranyl hydroquinone derivatives from Cordia alliodora. X-Ray crystal and molecular structure of 1,2,3,3a,4,9,10,10a-octahydro-5,8-dimethoxy-3,10-dimethyl-3a,9-epoxybenz[f]azulene

The aqueous acid-catalysed intramolecular cyclization of dimethylated alliodorin (2) obtained from the heartwood of Cordia alliodora has been characterized by X-ray analysis as the unusual tetracyclic di-O-methyl hydroquinone title compound (8). A new synthesis of di-O-methylalliodorin (2) from a terminal methylallylic sulphide derivative of 2-geranyl-1,4-dimethoxybenzene is described.Crystals of the title compound (8) are monoclinic, space group P21/c, unit cell dimensions a= 14.984(7), b= 5.206(4), c= 20.131(9)A, β= 99.77(1)°, Z= 4. The structure was solved by direct methods and refined by least-squares calculations to an R value of 0.078 for 1 832 independent reflections measured on a diffractometer using Cu-Kα radiation.
Patient-reported outcomes and digital literacy of patients treated in an oncology day hospital unit

Introduction Patient-reported outcomes (PROs) use, via a computer registry, allows patients to report their symptoms enabling the detection of early signs of progression of the disease. For such a record, the patient needs to show certain skills in new technologies use. The present study aimed to analyse the perception and degree of digital literacy of patients undergoing oncological treatment in an Oncology Day Hospital (ODH). Methods A cross-sectional descriptive study was performed, where the degree of literacy of patients attending antineoplastic treatment at the ODH was examined by means of an anonymous survey. Results A total of 122 patients have been included in the study. The proportion of subjects who use the electronic mail (TM) and the Internet on a daily basis was 45.1% and 70.5%, respectively, and up to 77.9% from the subjects considered that the use of digital 2.0 strategies could help improve communication between healthcare professional and patient. The TM was determined by the age, educational level and employment status of the individual. Furthermore, the age of the patients conditioned their perception of the usefulness of the web 2.0 tools (T2.0). Conclusion This study allowed us to establish a target patient profile to conduct the efficient monitoring of cancer progression by PROs. The results have shown that approximately 60% of the patients in our population could be potential candidates to receive PROs-based health care. This approach enables earlier detection of symptoms and signs of progression and consequently, improves health outcomes for cancer patients.
Significance of HIF-1α Expression and LOXL-2 Localization in Progression of Oral Squamous Cell Carcinoma

Backgroud: In the microenvironment of Oral Squamous Cell Carcinoma (OSCC), Hypoxia-inducible transcription factor 1 (HIF-1) is a very important chemical mediator in the microenvironment of OSCC through which cells respond to hypoxia. LOXL-2 participates in ECM remodelling, and also in regulating epithelial-to-mesenchymal transition, epithelial cell polarity and differentiation. Aim/material and methods: The present study was conducted on 90 histopathologically proven cases of OSCC to ascertain the role of HIF-1α and LOXL-2 in OSCC. Immunoexpression of both HIF-1α and LOXL-2 was analyzed both quantitatively and qualitatively and compared with tumor stage, nodal stage, clinical stage, and histological grade. Results: Tumor stages and nodal stages had significant correlation with HIF-1α expression and localization of LOXL-2 immunoexpression respectively. Conclusion: This is probably the first study to analyze LOXL-2 localization in OSCC. Alteration in the immunoexpression of LOXL-2 from nuclear to cytoplasmic and HIF-1α immunoexpression might be an important factor in progression of OSCC.
Risk factors for calciphylaxis in Chinese hemodialysis patients: a matched case-control study

Abstract Introduction Calciphylaxis is a rare but potentially fatal disease commonly occurred in dialysis patients. Despite some previous studies on risk factors for calciphylaxis, there is still a lack of data from Chinese population. Methods The retrospective matched case–control study about calciphylaxis was performed in Zhongda Hospital affiliated to Southeast University. The case group involved 20 hemodialysis patients who were newly diagnosed with calciphylaxis from October 2017 to December 2018. The 40 noncalciphylaxis patients undergoing dialysis with the same age and duration of dialysis were randomly selected as controls. Results Most of calciphylaxis patients were male and elderly, while overweight people were more susceptible to the disease. Although incidence of secondary hyperparathyroidism was higher in calciphylaxis patients, the differences in duration of elevated serum intact parathyroid hormone (iPTH) and its highest value did not reach statistical significance compared with controls. No significant difference in warfarin therapy was discernible between two groups. The univariate regression analysis indicated that male, score of use of activated vitamin D and its analogues, corrected serum calcium level, serum phosphate, Ca × P product, iPTH, albumin, and alkaline phosphatase (ALP) level were significantly associated with calciphylaxis. Elevated levels of serum phosphate (OR 4.584, p = 0.027) and ALP (OR 1.179, p = 0.036), decreased level of serum albumin (OR 1.330, p = 0.013) were independent risk factors after multivariate analysis. Conclusion This is the first report of risk factors associated with calciphylaxis in China. Increased levels of serum phosphate and ALP, decreased level of serum albumin were vital high-risk factors for calciphylaxis in Chinese hemodialysis population.
Cognitive Reserve and Driving-Related Cognitive Abilities in a Sample of Oldest Old Drivers Undergoing Assessment of Fitness to Drive

This study examines the relationship between age, cognitive reserve (CR), and driving-related cognitive abilities in a sample of oldest old drivers undergoing evaluation of fitness to drive. Structural equation modeling was used to investigate the associations between age, CR, and performances to a standardized set of cognitive tests assessing fitness to drive. Education and work complexity were used as proxy measures of CR. The results showed both measures of CR, but not age, were significantly associated with higher general intelligence. Education also predicted higher decision speed, and decision speed partly mediated the effect of education on general intelligence. These findings suggest that over age of 80 years old, CR was a better predictor of driving-related cognitive abilities than age. Education was associated with better performance across different cognitive domains including processing speed.
WNT signaling in atrial fibrillation

The Wnt signaling pathway regulates physiological processes such as cell proliferation and differentiation, cell fate decisions, and stem cell maintenance and, thus, plays essential roles in embryonic development, but also in adult tissue homeostasis and repair. The Wnt signaling pathway has been associated with heart development and repair and has been shown to be crucially involved in proliferation and differentiation of progenitor cells into cardiomyocytes. The investigation of the role of the Wnt signaling pathway and the regulation of its expression/activity in atrial fibrillation has only just begun. The present minireview (I) provides original data regarding the expression of Wnt signaling components in atrial tissue of patients with atrial fibrillation or sinus rhythm and (II) summarizes the current state of knowledge of the regulation of Wnt signaling components’ expression/activity and the contribution of the various levels of the Wnt signal transduction pathway to the processes of the development, maintenance, and progression of atrial fibrillation.
Effect of CPC, Brij-35, and SDBS Surfactants on the Adsorption and Movement of Carbofuran in Indian Soils

Laboratory studies were conducted to determine adsorption and movement of carbofuran in aqueous surfactant-free and surfactant [(cationic, cetyl pyridinium chloride (CPC), non-ionic, polyoxyethylene lauryl ether (Brij-35) and anionic, sodium dodecyl benezene sulphonate (SDBS)] solutions of different critical micellar concentrations (1/2 × CMC, 1.0 × CMC, and 2 × CMC) in four different Indian soils using batch shake and soil thin layer chromatography (soil TLC) techniques. The measured equilibrium adsorption isotherms were in agreement with the Freundlich equation. Higher adsorption of carbofuran in both systems was observed on FRI silt loam (FSL) soil followed by Alampur silt loam (ASL), Kalai loam (KL), and Bhoran sandy loam (BSL) soils, as anticipated from Freundlich constant KF and distribution coefficient KD, in surfactant-free systems and KF* and KD* in surfactant-soil-water systems. The adsorption of carbofuran in surfactant-soil-water systems followed the order cationic > anionic > non-ionic at all CMCs studied. The Rf values obtained from soil TLC studies confirmed the above order of adsorption. The KD and KD* values were used to evaluate remediation efficiency (KD*/KD) of surfactants. Non-ionic surfactant, Brij-35, and anionic surfactant, SDBS, are favorable for remediating soil contaminated with carbofuran as KD*/KD ratio is less than 1.
COVID-19 Changed the Injury Patterns of Hospitalized Patients

INTRODUCTION Injury patterns are closely related to changes in behavior. Pandemics and measures undertaken against them may cause changes in behavior; therefore, changes in injury patterns during the coronavirus disease 2019 (COVID-19) outbreak can be expected when compared to the parallel period in previous years. STUDY OBJECTIVE The aim of this study was to compare injury-related hospitalization patterns during the overall national lockdown period with parallel periods of previous years. METHODS A retrospective study was completed of all patients hospitalized from March 15 through April 30, for years 2016-2020. Data were obtained from 21 hospitals included in the national trauma registry during the study years. Clinical, demographic, and circumstantial parameters were compared amongst the years of the study. RESULTS The overall volume of injured patients significantly decreased during the lockdown period of the COVID-19 outbreak, with the greatest decrease registered for road traffic collisions (RTCs). Patients' sex and ethnic compositions did not change, but a smaller proportion of children were hospitalized during the outbreak. Many more injuries were sustained at home during the outbreak, with proportions of injuries in all other localities significantly decreased. Injuries sustained during the COVID-19 outbreak were more severe, specifically due to an increase in severe injuries in RTCs and falls. The proportion of intensive care unit (ICU) hospitalizations did not change, however more surgeries were performed; patients stayed less days in hospital. CONCLUSIONS The lockdown period of the COVID-19 outbreak led to a significant decrease in number of patients hospitalized due to trauma as compared to parallel periods of previous years. Nevertheless, trauma remains a major health care concern even during periods of high-impact disease outbreaks, in particular due to increased proportion of severe injuries and surgeries.
Studies on cellulose degrading bacteria in tea garden soils.

Cellulose degrading bacteria of tea garden soil were isolated, screened in vitro and its characterization, in relation to cellulase activity, was studied. Among the 25 isolates, the five strains showed higher enzyme activity when compared to other strains. Cellulase activity was expressed at a higher level by strain CDB 12 when blotting paper was used as a cellulose source in comparison with the other two substrate sources incorporated with minimal salt medium and followed by CDB 13 and CDB 21 in blotting paper. Maximum growth of cellulose degradation bacteria (CDB) was recorded at 30°C and pH 7.0. Among the carbon sources tested, maximum growth was observed in glucose amended mineral salts medium followed by fructose and maltose. Ammonium sulphate, ammonium nitrate and potassium nitrate were good nitrogen sources for better survival of CDB isolates. The biomass were continuously removed and placed as such into the tea field, then native and proven CDB strains were applied and they played an important role on the degradation of harvested biomass, which required replenishment to maintain the sustainable productivity of tea.
Sex‐based differences in severity and mortality in COVID‐19

The current coronavirus disease (COVID‐19) pandemic caused by novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has a male bias in severity and mortality. This is consistent with previous coronavirus pandemics such as SARS‐CoV and MERS‐CoV, and viral infections in general. Here, we discuss the sex‐disaggregated epidemiological data for COVID‐19 and highlight underlying differences that may explain the sexual dimorphism to help inform risk stratification strategies and therapeutic options.
Neoantigen vaccine platforms in clinical development: understanding the future of personalized immunotherapy

ABSTRACT Introduction Derived from genetic alterations, cancer neoantigens are proteins with novel amino acid sequences that can be recognized by the immune system. Recent evidence demonstrates that cancer neoantigens represent important targets of cancer immunotherapy. The goal of cancer neoantigen vaccines is to induce neoantigen-specific immune responses and antitumor immunity, while minimizing the potential for autoimmune toxicity. Advances in sequencing technologies, neoantigen prediction ? algorithms,? and other technologies have dramatically improved the ability to identify and prioritize cancer neoantigens. These advances have generated considerable enthusiasm for ? the ? development of neoantigen vaccines. Several neoantigen vaccine platforms are currently being evaluated in early phase clinical trials including the synthetic long peptide (SLP), RNA, dendritic cell (DC), and DNA vaccine platforms. Areas covered In this review, we describe, evaluate the mechanism(s) of action, compare the advantages and disadvantages, and summarize early clinical experience with each vaccine platform. We provide perspectives on the future directions of the neoantigen vaccine field. All data are derived from PubMed and ClinicalTrials search updated in October 2020. Expert opinion Although the initial clinical experience is promising, significant challenges to the success of neoantigen vaccines include limitations in neoantigen identification and the need to successfully target the immunosuppressive tumor microenvironment.
Neuropsychiatric Symptoms in Patients with Dementia Associated with Increased Psychological Distress in Caregivers During the COVID-19 Pandemic.

BACKGROUND The social isolation imposed by COVID-19 pandemic can have a major impact on the mental health of dementia patients and their caregivers. OBJECTIVE We aim to evaluate the neurological decline of patients with dementia and the caregivers' burden during the pandemic. METHODS We performed a cross-sectional study. Caregivers of dementia patients following in the outpatient clinic were included. A structured telephone interview composed of the Neuropsychiatric Inventory Questionnaire (NPI-Q), Zarit Burden Interview (ZBI), Beck Depression (BDI) and Anxiety (BAI) Inventories to address cognitive, behavioral, and functional changes associated with social distancing during the Sars-Cov-2 outbreak. Patients were divided in two groups according to caregivers' report: with perceived Altered Cognition (AC) and Stable Cognition (SC). RESULTS A total of 58 patients (median age: 57 years [21-87], 58.6%females) and caregivers (median age: 76.5 years [55-89], 79.3%females) were included. Cognitive decline was shown by most patients (53.4%), as well as behavioral symptoms (48.3%), especially apathy/depression (24.1%), and functional decline (34.5%). The AC group (n = 31) presented increased behavioral (67.7%versus 25.9%, p = 0.002) and functional (61.3%versus 3.7%, p < 0.001) changes when compared to the SC group. In the AC group, ZBI, BDI, NPI-Q caregiver distress, and NPI-Q patient's severity of symptoms scores were worse than the SC group (p < 0.005 for all). CONCLUSION Patients' neuropsychiatric worsening and caregiver burden were frequent during the pandemic. Worsening of cognition was associated with increased caregivers' psychological distress.
Physicochemical and Catalytic Properties of a Modified Natural Clinoptilolite

Abstract Samples of natural clinoptilolite modified by treatment with NH4Cl or HCl solutions, followed by thermal treatments, have been characterized, and their catalytic activity evaluated, in o-xylene isomerization and ethanol dehydration reactions. The substitution of the compensating cations by NH4+ does not produce structural changes in the original material, but it opens the channels and increases its acidity and thermal stability. The treatment with HCl increases both the acidity and the effective diameter of the channels and pores but it produces an important loss of zeolite phase. Calcination of the acidic forms above 973 K leads to the breakdown of the zeolite structure. Catalytic activity of the samples is related to the surface acidity. For the original and NH4Cl-treated samples, however, the conversion of o-xylene is limited by the access of the reactant inside the channels of the zeolite. A comparative study with modified sepiolite in dehydration of ethanol has also been performed.
Diffusional Mass Transfer at Sediment–Water Interface of Cylindrical Sediment Oxygen Demand Chamber

Diffusional mass transfer of dissolved substances across the sediment–water interface in coastal waters is an important factor for realistic determination of sediment oxygen demand (SOD) and nutrient recycle. The benthic diffusive boundary layer inside a cylindrical chamber commonly deployed for in situ measurements of sediment oxygen demand is studied. In a series of laboratory experiments, the SOD is measured with the chamber operated in both continuous flow and batch modes, and a microelectrode is employed to measure the near bed dissolved oxygen (DO) profile for different chamber flows and sediment types. The dependence of the diffusive boundary layer thickness and the sediment–water mass transfer coefficient on the hydraulic parameters are quantified. Using the derived mass transfer coefficient, it is shown that for a given sediment type, the SOD is a function of the bulk DO concentration and chamber flowrate. The theoretical predictions are validated by both laboratory and field SOD data.