Miracle-dz/UniFAR-FTUs huggingface dataset:
Micrometastatic breast cancer cells in bone marrow at primary surgery: prognostic value in comparison with nodal status.

BACKGROUND Approximately 30% of the patients with primary breast cancer who have no axillary lymph node involvement (i.e., lymph node negative) at the time of surgery will relapse within 10 years; 10%-20% of the patients with distant metastases will be lymph node negative at surgery. Axillary lymph node dissection, as a surgical procedure, is associated with frequent complications. A possible alternative to nodal dissection in terms of prognosis may be the immunocytochemical detection of tumor cells in bone marrow. PURPOSE In a prospective study, the value of tumor cell detection (TCD) in bone marrow was compared with axillary lymph node dissection in the prognosis of primary breast cancer after surgery. METHODS Data from 727 patients with primary, operable breast cancer were included in the analysis. All patients had surgery, including axillary lymph node dissection, from May 1985 through July 1994 at the Women's Hospital of the University of Heidelberg (Federal Republic of Germany). Bone marrow aspiration at two sites on each anterior iliac crest was performed immediately after surgery while the patients were under general anesthesia. Most patients received some type of systemic adjuvant therapy. The monoclonal antibody 2E11, directed against the polymorphic epithelial mucin TAG12, was used to detect tumor cells in bone marrow samples. The association of TCD with recognized prognostic indicators was evaluated by means of chi-squared tests. Survival without the development of distant metastases (i.e., distant disease-free survival) and overall survival were estimated by use of the Kaplan-Meier method; the logrank test was used to compare survival curves. A multivariate Cox regression analysis with stratification according to adjuvant treatment type was used to assess the independent prognostic value of TCD in bone marrow in relation to other variables. Reported P values are two-sided. RESULTS Tumor cells were detected in the bone marrow of 203 (55%) of 367 lymph node-positive patients and in 112 (31%) of 360 lymph node-negative patients. TCD was associated with larger tumors (P < .001), lymph node involvement (P = .001), and higher tumor grade (i.e., more undifferentiated) (P = .002). After a median follow-up of 36 months, patients with tumor cells in their bone marrow experienced reduced distant disease-free survival and overall survival (both P values < .001). TCD was an independent prognostic indicator for both distant disease-free survival and overall survival that was superior to axillary lymph node status, tumor stage, and tumor grade. Among patients with tumors less than 2 cm in diameter, TCD was the most powerful predictor of outcome. CONCLUSIONS AND IMPLICATIONS TCD in the bone marrow of patients with breast cancer is a valuable prognostic tool associated with negligible morbidity. Prospective randomized studies should be performed to determine whether TCD might replace axillary lymph node dissection in a defined subgroup of patients with small tumors.
Improving the Net Benefits from Tourism for People Living in Remote Northern Australia

Tourism can be an important source of livelihoods at a destination level. Yet, while there are economic benefits associated with more tourists, there can also be costs to destinations in the form of negative environmental and social impacts. This paper illustrates tourism-related dilemmas for two remote regions within Australia’s tropical savannas where increasing visitor numbers are straining not only the very environmental assets that attract tourist, but also the host communities. The paper draws on research conducted under the auspices of the Tropical Savannas Management Cooperative Research Centre. Tourism impacts on the regions are described and, where possible, quantified and distributional effects discussed. Evidence is provided that host populations in the remote of Australia’s tropical savannas are willing to trade off environmental and social costs for economic benefits, but that this situation may not be ecologically sustainable. The regions are parts of much larger destinations and consequently peripheral to their concerns. The onus for sustainable tourism and regional development strategies therefore falls on local decision makers. The research presented here provides a framework for local decision makers and stakeholders to ask questions, collect relevant data, and proceed with informed debates and choices.
Early prediction of acute antidepressant treatment response and remission in pediatric major depressive disorder.

OBJECTIVE : Less than half of youths achieve remission (minimal to no symptoms) after acute antidepressant treatment. Early identification of who will or will not respond to treatment and achieve remission may help clinicians formulate treatment decisions and shorten the time spent on ineffective treatments. In a prospective open-label fluoxetine study, we investigate indicators of acute treatment response and remission. METHOD : One hundred sixty-eight children and adolescents, ages 7 to 18 years, with primary diagnoses of major depressive disorder received 12 weeks of fluoxetine treatment. The youths were evaluated using the Kiddie Schedule for Affective Disorders and Schizophrenia. The outcome measure included the Children's Depression Rating Scale-Revised. RESULTS : Positive first-degree family history of depression was the only baseline demographic and clinical characteristic that predicted a favorable treatment response (p =.01). The rate of symptom improvement, however, is a good indicator of acute treatment response. A significant symptom reduction (approximately 50%) by week 4 is needed to achieve remission at the end of acute treatment. CONCLUSIONS : This study demonstrated that the rate of symptom improvement during early weeks of acute fluoxetine treatment is a good indicator of remission. Treatment approach may be reevaluated and modified as early as week 4 during acute treatment.Clinical trials registration information-Determining Optimal Continuation Treatment Duration for Depressed Children and Adolescents. URL: http://www.clinicaltrials. gov. Unique identifier: NCT00332787.
Non-intrusive user identity provisioning in the internet of things

The Internet of Things (IoT) represents an evolutionary vision and a new era of such smart environments that encompass all identifiable things in a dynamic and interacting network of networks. Each user has wide interactions with a huge number of entities. It would be impractical to require users to confirm themselves every time they cross various network boundaries, as the frequent verification process would disrupt the users' normal activities and degrades the overall performance. This paper presents a service provisioning framework for IoT that relies on verifying user identity using a non-intrusive method of monitoring and inferring certain types of user activities. The framework helps in supporting the purpose of the IoT for being smart, boundless, easier and safer to improve people's lives. The proposed framework reduces the risk of identity theft that results from losing user devices, where the user identity is usually stored. It copes with the loss of the user's ID or people impersonating other people, and raises an alarm to block an intruder from being verified as a legitimate user.
Editorial: work-life balance: a matter of choice?

Work–life balance has come to the forefront of policy discourse in developed countries in recent years, against a backdrop of globalization and rapid technological change, an ageing population and concerns over labour market participation rates, particularly those of mothers at a time when fertility rates are falling (Organization for Economic Co-operation and Development [OECD], 2004). Within the European Union the reconciliation of work and family has become a core concern for policy and encouraged debate and policy intervention at national levels.
Effects of Volatile Anesthetics on Mortality and Postoperative Pulmonary and Other Complications in Patients Undergoing Surgery: A Systematic Review and Meta-analysis

Background:It is not known whether modern volatile anesthetics are associated with less mortality and postoperative pulmonary or other complications in patients undergoing general anesthesia for surgery. Methods:A systematic literature review was conducted for randomized controlled trials fulfilling following criteria: (1) population: adult patients undergoing general anesthesia for surgery; (2) intervention: patients receiving sevoflurane, desflurane, or isoflurane; (3) comparison: volatile anesthetics versus total IV anesthesia or volatile anesthetics; (4) reporting on: (a) mortality (primary outcome) and (b) postoperative pulmonary or other complications; (5) study design: randomized controlled trials. The authors pooled treatment effects following Peto odds ratio (OR) meta-analysis and network meta-analysis methods. Results:Sixty-eight randomized controlled trials with 7,104 patients were retained for analysis. In cardiac surgery, volatile anesthetics were associated with reduced mortality (OR = 0.55; 95% CI, 0.35 to 0.85; P = 0.007), less pulmonary (OR = 0.71; 95% CI, 0.52 to 0.98; P = 0.038), and other complications (OR = 0.74; 95% CI, 0.58 to 0.95; P = 0.020). In noncardiac surgery, volatile anesthetics were not associated with reduced mortality (OR = 1.31; 95% CI, 0.83 to 2.05, P = 0.242) or lower incidences of pulmonary (OR = 0.67; 95% CI, 0.42 to 1.05; P = 0.081) and other complications (OR = 0.70; 95% CI, 0.46 to 1.05; P = 0.092). Conclusions:In cardiac, but not in noncardiac, surgery, when compared to total IV anesthesia, general anesthesia with volatile anesthetics was associated with major benefits in outcome, including reduced mortality, as well as lower incidence of pulmonary and other complications. Further studies are warranted to address the impact of volatile anesthetics on outcome in noncardiac surgery.
The Evidence for Disease Modification in Parkinson's Disease

ABSTRACT Disease modification or slowing the progression of any neurodegenerative disorder represents a dire unmet need. There have been trials for several decades specifically designed to help evaluate whether a specific therapy might be able to slow the progression of Parkinson's disease (PD) or be disease modifying. Trials evaluating the use of coenzyme Q10, pramipexole, and levodopa suggest that these medications offer symptomatic benefit uniquely, while other studies reveal that rasagiline and selegiline may be disease modifying. This review will discuss in detail the design and results of clinical trials for varied medical therapies that were specifically undertaken to discern whether a particular treatment might be disease modifying in the treatment of PD.
Pathogenic Potential of Campylobacter ureolyticus

ABSTRACT The recent detection and isolation of the aflagellate Campylobacter ureolyticus (previously known as Bacteroides ureolyticus) from intestinal biopsy specimens and fecal samples of children with newly diagnosed Crohn's disease led us to investigate the pathogenic potential of this bacterium. Adherence and gentamicin protection assays were employed to quantify the levels of adherence to and invasion into host cells. C. ureolyticus UNSWCD was able to adhere to the Caco-2 intestinal epithelial cell line with a value of 5.341% ± 0.74% but was not able to invade the Caco-2 cells. The addition of two proinflammatory cytokines, tumor necrosis factor alpha (TNF-α) and gamma interferon (IFN-γ), to the cell line did not affect attachment or invasion, with attachment levels being 4.156% ± 0.61% (P = 0.270) for TNF-α and 6.472% ± 0.61% (P = 0.235) for IFN-γ. Scanning electron microscopy visually confirmed attachment and revealed that C. ureolyticus UNSWCD colonizes and adheres to intestinal cells, inducing cellular damage and microvillus degradation. Purification and identification of the C. ureolyticus UNSWCD secretome detected a total of 111 proteins, from which 29 were bioinformatically predicted to be secretory proteins. Functional classification revealed three putative virulence and colonization factors: the surface antigen CjaA, an outer membrane fibronectin binding protein, and an S-layer RTX toxin. These results suggest that C. ureolyticus has the potential to be a pathogen of the gastrointestinal tract.
Shared leadership in the implementation of re‐orientations

Based on the experience of a hotel corporation, it is argued that the implementation of a re‐orientation is more likely to be successful if its leadership is shared between a task‐oriented and a relations‐oriented leader. The paper builds on the work of Nadler and Tushman who, for re‐orientations, prescribed shared charismatic and instrumental leadership at the top as well as throughout an organization. However, a little bit of charisma can go a long way. In the implementation phase the critical roles to share are those of task and relations, close to where the change is taking place. The implications for research and for management are noted.
m3pl: A Work-FLOWS ontology extension to extract choreography interfaces

Cross-organisational interoperability is a key issue for success in B2B e-commerce applications. To achieve this interoperability, choreography descriptions are necessary that describe how the business partners can cooperate. In existing approaches, these choreography descriptions are independent of the internal workflows of the partners. We present a framework for extracting choreography interface descriptions from internal workflow models. Our approach comprises two steps: first we map internal workflow models into a intermediary formal model, then we generate choreography interfaces from it. In this paper we present m3pl, an ontology extension based upon the First Order Ontology for Web Services (FLOWS) [2]. The extensions provide relations to model workflow views and choreography interfaces.
The trouble with World Englishes

Ever since the 1980s, when research interest in the field of ‘World Englishes’ began to gather speed, the view of the English language around the world has been largely dominated by the construct of so-called ‘varieties’ of English. These varieties are usually given a geographical label (‘Singapore English’, ‘Welsh English’, ‘South African English’, ‘Fiji English’, etc), and are described in terms of their pronunciation, their grammar, and their vocabulary. The resulting anthologies (see e.g. Wells, 1982; Trudgill & Hannah, 1982; Kortmann et al., 2004) have contributed a lot to our understanding of how English varies globally, as well as to raising the profile of non-inner circle (Kachru, 1985) varieties, which had previously not benefited from as much attention.
Increase in group II excitation from ankle muscles to thigh motoneurones during human standing

In standing subjects, we investigated the excitation of quadriceps (Q) motoneurones by muscle afferents from tibialis anterior (TA) and the excitation of semitendinosus (ST) motoneurones by muscle afferents from gastrocnemius medialis (GM). Standing with a backward lean stretches the anterior muscle pair (TA and Q) and they must be cocontracted to maintain balance. Equally, forward lean stretches the posterior muscle pair (GM and ST) and they must be cocontracted. We used these conditions of enhanced lean to increase the influence of γ static motoneurones on muscle spindle afferents, which enhances the background input from these afferents to extrafusal motoneurones. The effects of the conditioning volleys on motoneurone excitability was estimated using the modulation of the on‐going rectified EMG and of the H reflex. Stimulation of afferents from TA in the deep peroneal nerve at 1.5–2 × MT (motor threshold) evoked early group I and late group II excitation of Q motoneurones. Stimulation of afferents in the GM nerve at 1.3–1.8 MT evoked only late group II excitation of ST motoneurones. The late excitation produced by the group II afferents was significantly greater when subjects were standing and leaning than when they voluntarily cocontracted the same muscle pairs at the same levels of activation. The early effect produced by the group I afferents was unchanged. We propose that this increase in excitation by group II afferents reflects a posture‐related withdrawal of a tonic inhibition that is exerted by descending noradrenergic control and is specific to the synaptic actions of group II afferents.
Microstructure of strongly sheared suspensions and its impact on rheology and diffusion

The effects of Brownian motion alone and in combination with an interparticle force of hard-sphere type upon the particle configuration in a strongly sheared suspension are analysed. In the limit Pe→∞ under the influence of hydrodynamic interactions alone, the pair-distribution function of a dilute suspension of spheres has symmetry properties that yield a Newtonian constitutive behaviour and a zero self-diffusivity. Here, Pe=γ˛a2/2D is the Péclet number with γ˛ the shear rate, a the particle radius, and D the diffusivity of an isolated particle. Brownian diffusion at large Pe gives rise to an O(aPe−1) thin boundary layer at contact in which the effects of Brownian diffusion and advection balance, and the pair-distribution function is asymmetric within the boundary layer with a contact value of O(Pe0.78) in pure-straining motion; non-Newtonian effects, which scale as the product of the contact value and the O(a3Pe−1) layer volume, vanish as Pe−0.22 as Pe→∞.
Modeling Iso-Ahola’s Motivation Theory in the Tourism Context

Iso-Ahola’s theory asserts that personal escape, personal seeking, interpersonal escape, and interpersonal seeking motivate tourism and recreation. This article operationalizes and empirically tests Iso-Ahola’s theory for similar tourism and recreation experiences. The motivation dimensions are monitored using scenario-based data for sporting events, beaches, amusement parks, and natural parks. The first investigation used confirmatory factor analysis to explore the efficacy of six competing motivational structures. Three of these competing models achieved superior and similar fit statistics, with one model incorporating the most parsimonious structure. This model gave equal and direct salience to each of the four motivations. The second investigation examined the differences in motivation levels for tourism and recreation experiences. Tourism experiences exhibited higher levels of motivation, particularly for the personal seeking and personal escape dimensions. The third investigation found no relationship between the number of recent domestic and international vacations and tourism motivations among the subjects.
[Usefulness of comorbidity indices in operative gastric cancer cases].

OBJECTIVES The purpose of the current study was to evaluate the usefulness of the following four comorbidity indices in gastric cancer patients who underwent surgery: Charlson Comorbidity Index (CCI), Cumulative Illness rating scale (CIRS), Index of Co-existent Disease (ICED), and Kaplan-Feinstein Scale (KFS). METHODS The study subjects were 614 adults who underwent surgery for gastric cancer at K hospital between 2005 and 2007. We examined the test-retest and inter-rater reliability of 4 comorbidity indices for 50 patients. Reliability was evaluated with Spearman rho coefficients for CCI and CIRS, while Kappa values were used for the ICED and KFS indices. Logistic regression was used to determine how these comorbidity indices affected unplanned readmission and death. Multiple regression was used for determining if the comorbidity indices affected length of stay and hospital costs. RESULTS The test-retest reliability of CCI and CIRS was substantial (Spearman rho=0.746 and 0.775, respectively), while for ICED and KFS was moderate (Kappa=0.476 and 0.504, respectively). The inter-rater reliability of the CCI, CIRS, and ICED was moderate (Spearman rho=0.580 and 0.668, and Kappa=0.433, respectively), but for KFS was fair (Kappa=0.383). According to the results from logistic regression, unplanned readmissions and deaths were not significantly different between the comorbidity index scores. But, according to the results from multiple linear regression, the CIRS group showed a significantly increased length of hospital stay (p<0.01). Additionally, CCI showed a significant association with increased hospital costs (p<0.01). CONCLUSIONS This study suggests that the CCI index may be useful in the estimation of comorbidities associated with hospital costs, while the CIRS index may be useful where estimatation of comorbiditie associated with the length of hospital stay are concerned.
A‐kinase anchoring proteins: From protein complexes to physiology and disease

Protein scaffold complexes are a key mechanism by which a common signaling pathway can serve many different functions. Sequestering a signaling enzyme to a specific subcellular environment not only ensures that the enzyme is near its relevant targets, but also segregates this activity to prevent indiscriminate phosphorylation of other substrates. One family of diverse, well‐studied scaffolding proteins are the A‐kinase anchoring proteins (AKAPs). These anchoring proteins form multi‐protein complexes that integrate cAMP signaling with other pathways and signaling events. In this review, we focus on recent advances in the elucidation of AKAP function. © 2009 IUBMB IUBMB Life, 61(4): 394–406, 2009
The Impact of Leadership Changes on Expectations of Organizational Performance

Previous research has examined the effect of changes in upper management positions on actual organizational performance; however, the influence of leadership changes on performance expectations has been largely neglected. This gap in the literature is surprising given that failure to meet expectations leads to dismissal. The purpose of the present research is to analyze how coaching changes affect expectations of a sports team’s performance. Betting lines are used as performance expectations because they are unbiased forecasts of game outcomes. This study uses data from 13 seasons of the German Football Bundesliga. Significant positive timelagged effects on performance expectations are evident when examining underlying expected performance. These positive effects are evident 8 weeks after the leadership change, indicating that new leaders are expected to need some time before significant performance improvements are expected to occur.