Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of Parental Involvement in Life-Support Decisions: A Qualitative Analysis of Parents' Adjustment Following Their Critically Ill Child's Death

A retrospective, qualitative, preliminary study examined if parental involvement in a life-support withdrawal (LSW) decision impacts the perceptions and adjustment of parents whose child died in a pediatric critical care unit. Participants were parents whose child died following an LSW decision (11 mothers, 7 fathers) and parents whose child died without an LSW decision (5 mothers, 4 fathers). At 6 to12 months after their child's death, the two groups of parents were interviewed and asked to reexamine their perceptions of the following categories: understanding of child's medical condition, staff communication, support, and feelings of closure. Content analysis of the interview data indicated that in comparison to parents whose child died without an LSW decision, a significantly greater number of parents whose child died following an LSW decision were certain about their child's future health; believed that their child's quality of life would have been unacceptable; and reported less dissatisfaction with time spent with their child, fewer negative changes in family functioning, and more positive changes in feelings toward staff.
A Composite Photographic Image – could it Replace a Lateral Cephalogram?

Introduction Computer software allows a photograph of patient's face and a photograph of their dental casts to be combined into one image, similar to that seen in a lateral cephalogram. The aim of this study was to assess the agreement between the measurements carried out on this novel composite photographic image and those taken from a lateral cephalogram of the same patient. Methods The method involved the superimposition of a photograph of a patient's dental casts onto a photograph of their profile thus creating a composite image. The position of teeth in relation to the face was then compared on these images and on lateral cephalograms. The distances between a number of facial reference points to the upper right central incisor and the upper right last molar, were measured on both images. Results The records of 34 participants showed that there was good or acceptable agreement between measurements carried out on composite images and on lateral cephalograms. This agreement was generally better for measurements carried out from the reference points to the incisor tooth than to the molar. However, standard deviations of the mean differences between measurements were relatively high. Conclusions The photographic superimposition method eliminates exposure to ionizing radiation and is relatively inexpensive. However, it is not reliable enough to deliver accurate information on the position of teeth in the face.
Synergistic effect of piperonyl butoxide on acute toxicity of pyrethrins to Hyalella azteca

A series of acute toxicity tests with the amphipod Hyalella azteca was performed to quantify the synergistic effect of piperonyl butoxide (PBO) on pyrethrin toxicity. Concentrations of PBO <4 µg/L caused no toxicity enhancement, whereas toxicity increased with PBO concentrations between 4 µg/L and 15 µg/L. Additive toxicity calculations showed that true synergism accounted for an increase in pyrethrin toxicity (decrease in median lethal concentration) of 1.4‐fold to 1.6‐fold and varied only slightly between 4 µg/L and 15 µg/L PBO, whereas direct toxicity of PBO accounted for an additional increase in mixture toxicity (up to 3.2‐fold) that was proportional to PBO concentration. The results can be used to assess the risk of measured or predicted co‐occurring concentrations of PBO and pyrethrins in surface waters. Environ Toxicol Chem 2016;35:2111–2116. © 2016 SETAC
A multicenter comparison study between the Endosafe PTS rapid-release testing system and traditional methods for detecting endotoxin in cell-therapy products.

BACKGROUND Rapid-release testing reduces the waiting period for administration of time-sensitive cell-therapy products. Current assay systems are labor intensive and time consuming. The Endosafe portable test system (PTS) is a chromogenic Limulus amebocyte lysate (LAL) portable endotoxin detection system that provides quantitative results in approximately 15 min. To evaluate Endosafe performance with cell-therapy products, side-by-side testing of traditional LAL systems and the Endosafe system was conducted at the Production Assistance for Cellular Therapies (PACT) facilities and the National Institutes of Health's Department of Transfusion Medicine, USA. METHODS Charles River Laboratories provided each center with a PTS reader and two commercially prepared lyophilized reference standard endotoxin (RSE) vials. All samples tested with the Endosafe system used 0.05-5.0 endotoxin unit/mL (EU/mL) sensitivity cartridges provided by Charles River. Each vial was reconstituted with LAL water and tested in triplicate using the Endosafe and in-house LAL methods. Subsequently, each center tested the endotoxin content of standard dilutions of cell-therapy products, thus creating paired test results for each sample. Additionally, fabricated endotoxin-positive samples containing varying concentrations of endotoxin were prepared and shipped to all centers to perform blinded testing. RESULTS Valid paired results, based on each center's LAL method and the Endosafe system criteria, were analyzed. Endotoxin detection between paired results was equivalent in most cases. DISCUSSION The Endosafe system provided reliable results with products typically produced in cell-therapy manufacturing facilities, and would be an appropriate test on which to base the release of time-sensitive cell-therapy products.
Factors modulating circulation of hematopoietic progenitor cells in cord blood and neonates.

BACKGROUND Hematopoietic progenitor cells (HPC) circulate at high levels at birth and disappear rapidly afterwards, but the underlying mechanism it is not known. The aim of this study was to assess circulating HPC in cord blood at different gestational ages and shortly after birth and concomitantly study the biologic markers involved in this phenomenon. METHODS All samples were analyzed for CD34(+) cells, colony-forming units (CFU) and cytokines. RESULTS The results obtained confirmed a slight decrease in HPC concentration during the late stage of fetal life (R(2)=0.41). After birth, CD34(+) cells showed a rapid decline from circulation: 25+/-29% at 3 h, 51+/-42% at 12 h and 80+/-48% at 60 h. CFU cleared following a similar pattern. Cord plasma showed higher concentrations of stem cell factor (SCF), fetal liver tyrosine kinase 3-ligand (FLT3l), erythrpoietin (EPO), granulocyte colony-stimulating factor (G-CSF) and interleukin-11 (IL-11) compared with an adult control. Interestingly, the EPO concentration in newborn plasma correlated with the kinetics of HPC decline after birth. Moreover, we observed an up-regulation of l-selectin and a down-regulation of CXCR4 expression in CD34(+) cells 3 h after birth. DISCUSSION These data combined suggest that an active homing process results in the clearance of HPC from the circulation immediately after birth.
Interaction of single‐walled carbon nanotubes and saxitoxin: Ab initio simulations and biological responses in hippocampal cell line HT‐22

Saxitoxins (STXs) are potent neurotoxins that also induce cytotoxicity through the generation of reactive oxygen species. Carbon nanotubes (CNTs) are nanomaterials that can promote a Trojan horse effect, facilitating the entry of toxic molecules to cells when adsorbed to nanomaterials. The interaction of pristine single‐walled (SW)CNTs and carboxylated (SWCNT‐COOH) nanotubes with STX was evaluated by ab initio simulation and bioassays using the cell line HT‐22. Cells (5 × 104 cells/mL) were exposed to SWCNT and SWCNT‐COOH (5 μg mL−1), STX (200 μg L−1), SWCNT+STX, and SWCNT‐COOH+STX for 30 min or 24 h. Results of ab initio simulation showed that the interaction between SWCNT and SWCNT‐COOH with STX occurs in a physisorption. The interaction of SWCNT+STX induced a decrease in cell viability. Cell proliferation was not affected in any treatment after 30 min or 24 h of exposure (p > 0.05). Treatment with SWCNT‐COOH induced high reactive oxygen species levels, an effect attenuated in SWCNT‐COOH+STX treatment. In terms of cellular oxygen consumption, both CNTs when coexposed with STX antagonize the toxin effect. Based on these results, it can be concluded that the results obtained in vitro corroborate the semiempirical evidence found using density functional theory ab initio simulation. Environ Toxicol Chem 2017;36:1728–1737. © 2016 SETAC
Burden and psychological challenges in caregivers of children with intellectual disabilities in a child neurology clinic in Lagos, Nigeria

Abstract Background: Informal caregivers play an important role but may be strained while providing support for children with Intellectual Disabilities (ID), especially in resource poor nations. Aim: The study aimed to determine the severity of caregiving burden among care givers of children with ID and factors associated with such burden. Methodology: The study was cross-sectional and descriptive in nature and participants (study group) were caregivers of children with ID attending the clinic at the Lagos University Teaching Hospital (LUTH) while the control group were caregivers of children with acute medical illness. Instruments: included a sociodemographic questionnaire, a questionnaire on mothers attitude to mental retardation, the Zarit burden interview (ZBI) and the Zung self-rating depression scale (ZDS). Results: The majority of the caregivers were mothers, 90·6% in the study group and 88·2% in the control group. There were significant differences about the understanding of the illnesses among both cases and controls (P = 0·011). The caregivers in the study group (chronic cases) had higher mean scores than the caregivers in the control group (acute cases) on the Burden Scale. The difference in mean burden scores between the two groups was statistically significant (P = 0·016). Conclusion: There is a significant burden experienced by Caregivers of children with intellectual disabilities in the study location and this should be a focus of attention for health service providers that may be attending to these children.
Identification of sources of metal in the agricultural soils of the Guanzhong Plain, northwest China

A comprehensive survey was conducted to assess the possible sources and distribution of metals in the agricultural soils of the Guanzhong Plain in northwest China. In total, 227 samples of agricultural soil were collected to determine the content of Pb, Cr, Co, V, Ni, Zn, Cu, As, and Mn by X‐ray fluorescence spectrometry. The mean concentrations of metals were 26.2 ± 10.8 mg kg–1, 71.5 ± 16.8 mg kg−1, 12.7 ± 1.81 mg kg−1, 85.1 ± 7.86 mg kg−1, 30.5 ± 6.17 mg kg−1, 71.1 ± 14.1 mg kg−1, 25.2 ± 5.58 mg kg−1, 12.5 ± 1.94 mg kg−1, and 635.4 ± 84.7 mg kg−1 for Pb, Cr, Co, V, Ni, Zn, Cu, As, and Mn, respectively—slightly higher than the regional background values. Multivariate analysis was used to identify the metal sources, and it was found that Ni and Cr in the agricultural soils were mainly derived from lithological materials, and Pb, Zn, and Cu were mainly from traffic emissions; however, Zn and Cu also originated from mineral fertilizers or pesticides. The other metals originated from industrial emissions. The Nemerow index coupled with geographic information system technology was applied to assess the degree and spatial distribution of metal contamination; the soils studied were classified as slightly polluted, and the most contaminated regions were concentrated in the area surrounding Xi'an city, as well as areas in the southeast and north of the Guanzhong Plain. Environ Toxicol Chem 2017;36:1510–1516. © 2016 SETAC
New developments in the pharmacotherapeutic management of heart failure in elderly patients: concerns and considerations

ABSTRACT Introduction: Heart failure (HF) remains a major public health problem worldwide, affecting approximately 23 million patients, and is predominantly a disease of the elderly population. Elderly patients mostly suffer from HF with preserved ejection fraction (HFpEF), which often presents with multiple co-morbidities and they require multiple medical treatments. This, together with the heterogeneous phenotype of HFpEF, makes it a difficult syndrome to diagnose and treat. Areas covered: Although HF is most abundant in the elderly, this group is still underrepresented in clinical trials, which results in the lack of evidence-based medical regimens. The current review has focused on new potential therapies for this poorly studied population. The focus will be on several classes of drugs currently recommended or might be expected soon. These will include sacubitril/valsartan (former LCZ696), Omecamtiv mecarbil, Vericiguat, Ivabradine, mineralocorticoid receptor antagonists (MRAs) and potassium binders. Expert opinion: We discuss promising new treatments and hypothesize that personalized approaches will be needed to treat elderly patients optimally. Medical doctors should not only focus on HF therapy, but comorbidities and polypharmacy should also influence therapeutic decision making. Furthermore, the importance of quality of life as a management endpoint should not be underestimated in the frail elderly.
Assessing and optimizing health-related quality of life during and after cancer treatment in adolescents and young adults

: Adolescent and young adults (AYAs) with cancer have needs unique from their pediatric or adult counterparts at diagnosis, during treatment, and throughout survivorship care. Healthcare teams may find it difficult to assess and manage the complex psychosocial needs of AYA patients, however, attention to the multi-faceted care of the AYA oncology patient may directly affect health outcomes and quality of life. Comprehensive AYA care therefore must be maximized during treatment and in transition to survivorship care by including assessments of general health, sexual health, mental health, health behaviors, and conversations concerning transition to survivorship and adulthood with AYA patients. Identifying and treating issues that arise in the AYA population may help promote adherence to treatment, engagement in follow-up care, and ultimately quality of life for this unique group of patients.
Chronic effects of copper in oysters Crassostrea hongkongensis under different exposure regimes as shown by NMR‐based metabolomics

Traditional metal toxicity tests on organisms have mainly focused on continuous exposure at a fixed concentration. However, organisms are more likely exposed to pollutants intermittently in estuarine environments that are significantly impacted by anthropogenic activity. The present study examined whether different copper (Cu) exposure regimes at an equivalent dose can induce different metabolomics effects on the oysters. An estuarine oyster Crassostrea hongkongensis was exposed to Cu continuously or intermittently at an equal dose (time × concentration) for 6 wk. Continuous exposure regimes included 2 doses of 3.3 μg/L for 24 h and 20 μg/L for 24 h, with corresponding equal doses of 2 intermittent exposure regimes of 20 μg/L for 4 h and 120 μg/L for 4 h, respectively. Time‐course measurements suggested that Cu bioaccumulation was comparable at equal low doses between the continuous regime (3.3 μg/L for 24 h) and the intermittent regime (20 μg/L for 4 h), but there was considerable difference for the high dose under different regimes. Nuclear magnetic resonance (NMR)‐based metabolomics suggested that continuous and intermittent Cu exposures led to similar metabolite variation pattern in gills at an equal high dose, including decreased amino acids (e.g., aspartate, glycine, isoleucine, leucine, lysine, phenylalanine, threonine, and valine), lower energy‐related compounds (e.g., adenosine triphosphate/adenosine diphosphate, acetate, citrate, and glycogen), and altered osmolytes (e.g., homarine and taurine). These biomarkers indicated disturbance of osmotic regulation and energy metabolism induced by Cu exposure regardless of regime. In addition, the 4‐h intermittent Cu exposure resulted in slightly fewer adverse effects compared with the corresponding equal‐dose continuous exposure. Oysters appeared to recover during the intervals of Cu exposure. The results indicated that metabolomic effects induced by Cu were more dose dependent than the Cu exposure regime. Environ Toxicol Chem 2017;36:2428–2435. © 2017 SETAC
SIMONI (Smart Integrated Monitoring) as a novel bioanalytical strategy for water quality assessment: Part I–model design and effect‐based trigger values

It is virtually impossible to reliably assess water quality with target chemical analyses only. Therefore, a complementary effect‐based risk assessment by bioanalyses on mixtures of bioavailable micropollutants is proposed: the Smart Integrated Monitoring (SIMONI) strategy. The goal of this strategy is to obtain more reliable information on the water quality to select optimum measures for improvement. The SIMONI strategy is 2‐tiered. Tier 1 is a bioanalytical hazard identification of sites. A tier 2 ecological risk assessment is carried out only at a limited number of sites where increased hazards are detected in tier 1. Tier 2 will be customized, based on tier 1 evaluation and additional knowledge of the aquatic system. The present study focuses on the tier 1 bioanalytical hazard identification to distinguish “hot spots” of chemical pollution. First, a selection was made of relevant and cost‐effective bioanalytical endpoints to cover a wide spectrum of micropollutant modes of action. Specific endpoints may indicate which classes of chemicals might cause adverse effects. Second, effect‐based trigger values (EBT) were derived for these bioassays to indicate potential ecological risks. Comparison of EBT with bioassay responses should discriminate sites exhibiting different chemical hazards. Third, a model was designed to estimate the overall risks for aquatic ecosystems. The associated follow‐up for risk management is a “toxicity traffic light” system: green, low hazard (no action required); orange, potential risk (further research needed); and red, high risk (mitigation measures). Thanks to cost‐effectiveness, flexibility, and relevance, the SIMONI strategy has the potential to become the first bioanalytical tool to be applied in regular water quality monitoring programs. Environ Toxicol Chem 2017;36:2385–2399. © 2017 SETAC
Contralateral acoustic hearing aid use in adult unilateral cochlear implant recipients: Current provision, practice, and clinical experience in the UK

Objectives: The study surveyed practising cochlear implant (CI) audiologists with the aim of: (1) characterizing UK clinical practice around the management and fitting of a contralateral hearing aid (HA) in adult unilateral CI users (‘bimodal aiding’); (2) identifying factors that may limit the provision of bimodal aiding; and (3) ascertaining the views of audiologists on bimodal aiding. Methods: An online survey was distributed to audiologists working at the 20 centres providing implantation services to adults in the UK. Results: Responses were received from 19 of the 20 centres. The majority of centres reported evaluating HAs as part of the candidacy assessment for cochlear implantation. However, a majority also indicated that they do not take responsibility for the contralateral HA following implantation, despite identifying few practical limiting factors. Bimodal aiding was viewed as more beneficial than wearing the implant alone, with most respondents actively encouraging bimodal listening where possible. Respondents reported that fitting bimodal devices to take account of each other's settings was potentially more beneficial than independently fit devices, but such sympathetic fitting was not routine practice in any centre. Discussion: The results highlight some potential inconsistencies in the provision of bimodal aiding across the UK as reported by practising audiologists. The views of audiologists about what is best practice appear to be at odds with the nature and structure of the services currently offered. Conclusion: Stronger evidence that bimodal aiding can be beneficial for UK patients would be required in order for service providers to justify the routine provision of bimodal aiding and to inform guidelines to shape routine clinical practice.
Aberrant p53 protein expression and function in a panel of hematopoietic cell lines with different p53 mutations

The p53 gene is one of the most important genes involved in carcinogenesis and its role in part has been clarified by research using cell lines. To know the comprehensive characteristics of 22 hematopoietic cell lines (T, 13 and non‐T, nine lines), the relationship between p53 mutational status, its altered functioning, and its mRNA and protein levels were examined. p53 mutations were less frequent in T‐cell lines (38% vs. 78%) with mainly single nucleotide substitutions generating missense codons. Of 22 different p53 mutations, 12 (54.5%) resulted in mutated proteins, with the mutations clustering mainly in the sequence‐specific DNA‐binding site region located from amino acid residues 102 to 292. p53 mRNA and protein assays determined that wild‐type cell lines expressed constant levels of both mRNA and protein, but mutated cell lines demonstrated two expression patterns: protein over‐expression with reduced mRNA levels, because of missense mutations; and protein under‐expression with little mRNA expression, because of other mutations. The resistance to Nutlin (MDM2 inhibitor)‐induced apoptosis was associated with p53 mutations independently of MDM2 expression levels. This clarification of the unique associations in cell lines useful for bio‐medical studies will contribute to a better understanding of p53‐associated carcinogenesis.
Hearing preservation cochlear implantation in children: The HEARRING Group consensus and practice guide

Objectives: To provide multidisciplinary cochlear implant teams with a current consensus statement to support hearing preservation cochlear implantation (HPCI) in children, including those children with symptomatic partial deafness (PD) where the intention is to use electric-acoustic stimulation (EAS). The main objectives are to provide guidelines on who is a candidate, how to assess these children and when to implant if Med-El Flex electrode arrays are chosen for implantation. Methods: The HEARRING group reviewed the current evidence and practice regarding the management of children to be considered for HPCI surgery emphasizing the assessment needed prior to implantation in order to demonstrate the benefits in these children over time. The consensus statement addresses following three key questions: (1) Should these children be treated? (2) How to identify these children? (3) How to manage these children? Summary: The HEARRING group concludes that irrespective of the degree of residual hearing present, the concepts of hearing and structure preservation should be applied in every child undergoing cochlear implantation and that HPCI is a safe and reliable treatment option. Early detection and multidisciplinary assessment are key to the identification of children with symptomatic PD, these children should undergo HPCI as early as possible.