Miracle-dz/UniFAR-FTUs huggingface dataset:
'Sacraments' in the Hospital: Exploring the Magic and Religion of Recovery Sjaak van der Geest

This article proposes to look at the ritual dimension of hospital work, a chain of words and acts, which fill patients with hope for a ‘future life’. Conventional boundaries between magic, science and religion are reconsidered. The author argues that biomedicine, far from being a cultural no-man’s land, represents the basic values of culture. It provides a space where doctors, nurses and patients find their deepest convictions and values demonstrated and confirmed. Medical words and interventions express and re-create people’s belief in the canons of science and biomedicine as ultimate truth. Pointing out the religious dimension of medicine in no way belittles medicine’s role and therapeutic efficacy. Rather it provides us with a better understanding of the ‘mechanics’ of recovery. Hospitals in the ‘Western world’ have been characterised as places of secularisation at the fringes of life. While it has been commonly observed that religion becomes more prominent when life is in jeopardy, the opposite seems to happen in modern hospitals where religious agents have become nearly out of place, at least in my own society, The Netherlands. Medical scientists and technicians have taken over the role of priests and other religious specialists in times of crisis and in the face of death. Such, at least, is the popular view. Medicine has become thoroughly secularised. The purpose of this article is to point out that this view of hospitals as unreligious places is based on a misunderstanding of what religion and science are. The con
Polymorphisms in VEGF, eNOS, COX-2, and IL-8 as predictive markers of response to bevacizumab.

e13502 Background: There are no validated predictive markers for selecting patients who would respond to bevacizumab. Previous studies analyzed the role of SNPs in VEGF, eNOS, COX-2, IL-8, but no definite prognostic and predictive association has been established. We evaluated the association of genetic variability with outcome in patients (pts) treated with bevacizumab. Methods: Fifty metastatic pts affected by colorectal (35/50), breast (11/50), and kidney (4/50) cancer were included in this study. VEGF936 C/T and VEGF2578 C/A, eNOS894 G/T, eNOS786 T/C, COX-2 8473 C/T, IL-8 251 T/A polymorphisms were selected. All pts were treated with bevacizumab plus chemotherapy (colorectal and breast cancer) or IFN (renal cancer). Response rate was related to polymorphic gene expression. The relationship of TTP/OS to SNPs is too early because most pts are still alive. The association between response and genotypes was evaluated using the Chi-square test. Results: 29/50 (58%) pts had a partial response, one patient h.
Relapsed or Relapsed/Refractory Multiple Myeloma

Multiple myeloma (MM) is a malignant plasma cell disorder with potential secondary organ effects including renal, bone, and bone marrow effects as well as neurologic and immune dysfunction. Diagnostic evaluation of MM includes laboratory and radiologic studies along with bone marrow biopsy to confirm diagnosis. Multiple myeloma is a clonal plasma cell malignancy that results from complex interactions between malignant progenitor cells, bone marrow stromal cells, and the bone marrow microenvironment. Multiple myeloma is clinically and pathologically heterogeneous, which results in variability in treatment response and survival. The disease trajectory varies for each patient, but relapses are inevitable and many patients become refractory to treatments. Management of relapsed and refractory (RR) MM requires careful evaluation of individual patient characteristics and the course of the disease. When determining treatment options for patients with RR MM, comorbidities, the frailty and vulnerability of the patient, and the specific adverse event profile associated with each treatment should be considered, as well as the patient's goals. The goal of therapy for patients with RR MM is to achieve disease control with acceptable toxicity and quality of life, which may be accomplished with novel agents, most likely in combination regimens. The integration of these novel agents into the treatment paradigm has shifted the perception of MM from incurable to a disease that may be considered chronic in the near future with a hope for long-term survival and maintained quality of life. J Adv Pract Oncol 2013;4(Suppl 1):5-14
Optimising parenteral nutrition for the very preterm infant

This article reviews the relationship between neonatal parenteral nutrition (PN) and early postnatal growth failure in the very preterm infant. The implications for long-term neurodevelopmental outcome for these infants are considered. The evidence base for different neonatal PN macronutrient contents, formulations and methods of administration is explored. A new concept is proposed: standardised, concentrated neonatal parenteral nutrition, to allow consistent nutrient delivery in the early neonatal period.
Reinforcing, subject-rated, performance and physiological effects of methylphenidate and d-amphetamine in stimulant abusing humans

Methylphenidate has potential for abuse because it produces behavioural effects similar to those observed with other abused stimulants, such as d-amphetamine and cocaine. The aim of this study was to further characterize the abuse potential of oral methylphenidate relative to oral d-amphetamine. Ten drug-abusing volunteers were recruited to participate in this study, which consisted of seven dose conditions: methylphenidate (16, 32 and 48 mg), d-amphetamine (8, 16 and 24 mg) and placebo. The reinforcing effects of these drugs were assessed during a self-administration session (preceded by a sampling session for each condition) with a modified progressive-ratio procedure. Subject-rated, performance and physiological effects were assessed concurrently during both the sampling and self-administration sessions. The intermediate dose of methylphenidate and d-amphetamine increased responding significantly above placebo levels. Both methylphenidate and d-amphetamine produced dose-dependent increases in stimulant-like subject ratings (e.g. Active, Alert, or Energetic and High), but the effects of these drugs were not isomorphic. These findings are consistent with epidemiological data and previous findings from laboratory studies that suggest methylphenidate has at least some abuse potential.
Healthy Lifestyle Changes among Middle-Aged Americans: Education Differences in Changes and Adherence

There are well documented differences in morbidity and mortality by socioeconomic status in the U.S. This may be due in part to early life conditions and in part to later life circumstances. Research on SES differences in health behaviors and health outcomes has not fully addressed the role of health behavior change. In this analysis, I examine which middle-aged and older Americans make changes in health behaviors after reporting new chronic conditions for which lifestyle changes are important for the management of the conditions. I examine patterns of behavior change for smoking, drinking, and exercise as well as adherence to these changes and analyze education differences in behavior change and adherence. I find that no education differences in quitting smoking when reporting new chronic conditions or adherence to smoking cessation. Education is negatively associated with both healthy changes in alcohol consumption and adherence to this lifestyle change. Only the college educated are more likely to start exercising when reporting new conditions, and conditional on starting to exercise, education is positively associated with making exercise a sustained lifestyle change.
Influence of Ginseng, Curcumin and Their Combination on Rats Suffering from Diabetes and Acute Liver Diseases

This study was carried out to determine the effect of two levels from ginseng and curcumin and their combination on nutritional evaluation, kidney functions, lipid profile and liver enzymes of diabetic rats suffering from acute liver diseases. Forty-eight male albino rats (Sprague Dawley Strain) weighting an average of (150±5g) used in this study. The rats were divided into two main groups. The first main group (6 rats) was fed on basal diet as a (control negative group). The second main group (42 rats) treated with CCl , in paraffin oil (50% v/v 4 4 ml/kg) subcutaneous injection to induced acute damage in the liver. The second main group injected with (150mg alloxan/kg body weight) to induce hyperglycemia. The second main group was divided into seven subgroups (6 rats each). The first subgroup fed on basal diet as a control positive group. The second and third subgroups fed on basal diet containing 2% and 4% ginseng, respectively. The fourth and fifth subgroups fed on basal diet containing 0.25% and 0.5% curcumin, respectively. The sixth subgroup fed on basal diet containing (2% ginseng and 0.25% curcumin). The seventh subgroup fed on basal diet containing (4% ginseng and 0. 5% curcumin). The results revealed that, feed intake, body weight gain% and serum HDL-c decreased, while other parameters increased in the positive control group, as compared to the negative control group. Treating diabetic groups which were suffering from acute liver disease with 2% and 4% ginseng, 0.25% and 0.5% curcumin and their combination improved the weight gains, organs weight/body weight%, kidney functions (uric acid, urea nitrogen and creatinine), lipid profile (cholesterol, triglycerides, HDL-c, LDL-c and VLDL-c) and liver enzymes (AST, ALT and ALP), especially the groups which were treated with the high and low levels from the combination of (4% ginseng and 0.5% curcumin) and (2% ginseng and 0.25% curcumin), respectively.
Facteurs prédictifs de réponse et données de tolérance du tocilizumab au cours de la polyarthrite rhumatoïde

La polyarthrite rhumatoide (PR) represente le plus frequent des rhumatismes inflammatoires chroniques de l'adulte. Actuellement, le rhumatologue dispose d'un large choix de biomedicaments disponibles pour le traitement de la PR en seconde intention apres echec ou intolerance du methotrexate, dont le tocilizumab (TCZ) qui est le premier anticorps monoclonal inhibiteur de l'interleukine 6. Notre etude observationnelle et multicentrique a pour principal objectif de determiner les facteurs predictifs de reponse au tocilizumab (RoActemra®) au cours de la PR. L'identification d'un profil de patients repondeurs au TCZ pourrait permettre, en orientant le choix du prescripteur vers le TCZ pour ces patients, d'augmenter leurs chances de remission ; et d'autre part, de diminuer le risque d'echec du TCZ chez les autres patients pour lesquels sera prefere alors un autre biomedicament que le TCZ. Ce travail vise egalement a evaluer l'efficacite et la tolerance du TCZ dans une population de patients atteints de PR en conditions reelles d'utilisation. Notre etude confirme dans la "vraie vie" l'efficacite rapide (des la premiere perfusion) et croissante du TCZ dans le temps, ainsi que la bonne tolerance de ce biomedicament au cours de la PR. A part l'EVA, maladie qui semble plus faible a l'instauration du TCZ chez les patients en remission a 6 mois par rapport aux autres patients, aucun lien avec l'efficacite ne ressort significativement dans notre travail. Les facteurs mis en evidence dans certaines etudes controlees ne sont peut-etre pas suffisamment determinants pour transparaitre dans une etude a faible effectif telle que la notre. Pour choisir d'utiliser le TCZ au cours de la PR, il serait donc peut-etre plus interessant de se baser sur un faisceau d'arguments plutot que sur des facteurs precis.
Efficacy of azithromycin and tylosin against cryptosporidiosis

For therapeutic studies, 30 cryptosporidic calves were randomly divided into 3 groups each containing 10 animals. Ten healthy calves served as controls (Group I), calves in Group II served as infected untreated controls. Calves of Group III were treated with azithromycin while that of Group IV with tylosin. Dehydrated calves in Group III and IV were infused with Ringers lactate. Before therapy (in cryptosporidic calves), the mean haemoglobin (Hb) concentration, packed cell volume (PCV) and total leukocyte count (TLC) were significantly (P=0.01) decreased and relative differential leukocyte count (DLC) revealed mild neutropenia, lymphocytopenia, monocytosis and eosinophilia. Investigation on serum biochemical constituents revealed significant (P=0.01) decrease in serum glucose, total proteins, albumin globulin ratio and serum sodium and potassium levels. Following treatment with azithromycin and tylosin clinical recovery was much faster in azithromycin treated calves than in tylosin treated calves. The calves in Group II failed to regain haemato-biochemicallevels in normalcy even on day 42 of observation.
Bony Tubercle on the Posterior Border of Foramen Magnum - A Case Study

Presence of tubercles in the foramina of the cranium has aroused the curiosity of anatomists. The foramen magnum is the large opening situated in the occipital bone, and transmits important neurovascular structures. During routine study of skull in the department of Anatomy at DM - Wayanad Institute of Medical Sciences, Meppadi, Kerala, a triangular projection was found at the posterior margin of foramen magnum, with the apex directed forwards towards the anterior margin of foramen magnum. The tubercle measured 1.5mm antero-posteriorly and 1.5mm transversely.
Localization of Fibrillin-I in the Human Term Placenta

Objective: We determined the level of message for fibrillin-1, a single-stranded glycoprotein found in the elastic micropfibrils of the extracellular matrix, in human placenta compared with other adult human tissues and localized the protein int he term human placenta. Methods: Northern blot analysis using a cDNA specific for fibrillin-1 was used to compare message levels in several adult human tissues and placenta. Immunohistochemical staining, using a monoclonal antibody to human fibrillin-1, was used to visualize the sitz of fibrillin-1 in term human placenta. Results: Larger amounts of message for fibrillin-1 were present in placenta than in any of the other tissues tested. Staining for fibrillin-1 was present in the villous stroma but not in the basement membranes, trophoblast cells, or in blood vessels of stem, mature intermediate, or terminal villi. Conclusions: Fibrillin-1 is distributed extensively in the villous stroma of the term human placenta and may contribute elastic properties to the placenta and basal plate required for an active uterus.
Expression of Transforming Growth Factor (TGF)-β1 and TGF-β Type II Receptor in Preneoplastic Lesions During Chemical Hepatocarcinogenesis of Rats

Transforming growth factor (TGF)-b1 is an important apoptotic growth inhibitor of hepatocyte proliferation, and the expression of TGF-b1, which regulates cell proliferation, is closely associated with the expression level of TGF-b type II receptor (TGR2). Moreover, TGF-b1 expression has been regarded to be an important change in hepatocarcinogenesis . We undertook this study to investigate the gene expression and protein localization of TGF-b1 and TGR2 and their relationship with apoptosis in the chemically induced hepatocarcinogenesi s of the rat, as produced using Solt and Farber’s method, during the promotion stage (up to 56 days after partial hepatectomy). Northern blot analysis showed a slight, but not a signicant, increase in TGF-b1 transcripts, and a signicant decrease in the TGR2 transcripts during the later stage of our experiments (42 days after partial hepatectomy). Immunohistochemica l study showed that TGF-b1-positive preneoplastic hepatocytes increased with time, and this correlated with an increase of TGR2 negative or reduced TGR2 expressed preneoplastic lesions. The TUNEL method revealed that apoptotic cells increased with time and were more numerous in the adjacent liver parenchyme than preneoplastic lesions. Our data suggest that the expressions of TGF-b1 and TGR2 are signicantly altered during the promotion stage of hepatocarcinogenesi s of rat and that these changes might contribute to the developmen t and progression of preneoplastic lesions.
TREATMENT OF OSTEOCHONDRAL SYMPTOMATIC DEFECTS OF THE KNEE WITH SALUCARTILAGE

Although various treatment options are available, which include shaving, microfractures, abrasion arthroplasty osteochondral allografts and autografts, chondrocyte grafts and unicondylar prostheses, symptomatic articular cartilage defects represent a therapeutic challenge. Since November 2002, as a non-biological answer to the problem, we started using synthetic cartilage implants made of polyvinyl alcohol- hydrogel (PVA – H) (SaluCartilage). This is a transparent synthetic polymer with a molecular weight of 308,000 daltons and 20% of water content, available in cylindrical shape of various diameters. Following the second part of the OATS technique, under arthroscopic control and by mini-arthrotomy, or completely arthroscopically assisted, the cylindrical implant is inserted, using press-fit technique, into previously punched out and dilatated osteochondral defects. Our patients, whose mean age was 56 years (range 48–68 years) have been post-operatively reviewed clinically and by serial MRI exams. Patients showed significant improvement over pre-operative values in the IKDC score, with an average increase of 20 points. Follow-up MRI images revealed a normal healing process, without signs of osteolysis or wear. As complications we had one case of implant dislocation 1 year after surgery and one case of progressive loosening due to osteoarthritic disease, both of which have required a knee prosthesis. Our experience has led us to emphasise the use of this type of treatment only in cases that fullfil precise indications: (a) Third and fourth degree chondral or osteochondral symptomatic defects; (b) focal unicompartmental defects with 15 mm maximum extent; (c) patient’s age limited from fourth to seventh decade of life; and (d) absence of angular deformities or articular instabilities. The synthetic cartilage resurfacing technique has the advantages of no donor defect, one short-step surgical procedure, immediate weight-bearing and no extensive rehabilitation programme. Early results of first 15 patients are being presented, expecting a longer observation follow-up study.
Author's Reply

drugs on clinical laboratory tests. Clin Chern 1975; 21: 287D 8 Fossati P, Prencipe L, Berti G. Enzymic creatinine assay: a newclorimetric method based on hydrogen peroxide measurement. Clin Chern 1983; 29: 1494-6 9 Tanganelli C, Prencipe L, Bassi D, Cambiaghi S, MuradorE. Enzymic assay of creatinine in serum and urine withcreatinine iminohydrolase and glutamate dehydrogenase. Clin Chern 1982; 28: 1461-4
Modeling of torsion fatigue in shape memory alloys

Fatigue in shape memory alloys is one of the crucial aspects of their behavior; however, the current knowledge is mainly focused on uniaxial fatigue and is inadequate for engineering purposes. In this article, a fatigue criterion based on the stabilized dissipated energy has been presented to investigate the torsional low-cycle fatigue of superelastic shape memory alloys. To this aim, a one-dimensional torsional constitutive model in addition to a modified fully coupled thermomechanical model has been utilized so that the torsional cyclic responses especially in relatively high loading frequencies, which contribute to remarkable temperature variations and consequent response changes, could be taken into account. The calculated stabilized dissipated energy, then, has been used in an energy approach fatigue criterion in order to predict the fatigue life; hence, an explicit relation, which is capable of determining the number of cycles to failure for different loading conditions at a given loading frequency, has been obtained. The numerical results have been appraised for NiTi specimens, and they have been shown to be in a good agreement with the experimental data. Finally, using the proposed approach, the effect of fatigue test parameters on the fatigue life has been studied.
Anti-interleukin and associated receptors monoclonal antibodies therapy in autoimmune diseases

There are nearly 40 approved monoclonal antibodies (mABs) in the U.S. for different diseases. These drugs are increasingly using in different autoimmune diseases, including rheumatoid arthritis (RA), asthma, psoriasis, systemic lupus erythematosus (SLE), atopic dermatitis (AD), multiple sclerosis (MS), and type 1 diabetes (T1D). Several phase 2 and 3 studies reported the clinical improvement due to treating with mABs. However, some adverse events (AEs) such as infections, injection-site reactions are frequently reported. In addition to approved diseases, off-label uses also led to some new results, which may cause reviewing the drug for other diseases. In this review, it was tried to discuss on the role of mABs that target interleukins or their associated receptors in treatment of autoimmune diseases. Moreover, approval statues, efficiency, safety and the possible associated AEs of the mABs on the market, based on the least clinical trials were also discussed.
Response to Commentary

W welcome debate and comment on our work. Scientific argument is, of course, most constructive and fruitful when it is based on a thorough understanding of the techniques and theory on which the work is based. We examined the interrelationship between systematic and nonsystematic decision processes and individual characteristics that, on the basis of the Heuristic-Systematic Processing Model, might be expected to be related. The genesis for applying this theoretical approach to patient decision making lay in many years of clinical experience in both community and acute health care settings in which utility-based models often appear irrelevant in the face of patients’ treatment choices that are inconsistent with the medical evidence for benefit. In our view, investigating patient decision making in actual health decisions has value and the potential to add to current approaches to decision support. Translating our findings to clinical practice, eliciting from a patient the underlying lay belief or heuristic rule that may be influencing his decision making, provides the opportunity to challenge unhelpful cognitions that are not, in reality, salient to the decision at hand. Until this occurs, asking patients to systematically consider the pros and cons of treatment choices may be ineffective. We suggest that to expect patients to process personally relevant medical information in a manner consistent with a normative, formal logical model is to expect them to act as they never do in other domains. Human reasoning that departs from simple normative models involves a variety of forms such as heuristics. Various definitions of heuristics can be found for those interested, and in this regard, any process of theory building or extension will profit from considering other disciplinary approaches. Kahneman has described heuristics as lying within the category of intuitive judgments that are automatic, associative, effortless, implicit, and often emotionally charged. The accessibility of these intuitive judgments is determined, at least in part, by the characteristics of the stimulus and events that evoke it. Our results are consistent with this, suggesting that individuals’ past experiences with cancer, their beliefs about health, and their perceptions of and discomfort with uncertainty influence their decision processes. This proposition does not seem outrageous. Finally, it has been previously suggested that a dual processing model that investigates the interplay of intuitive and effortful processing modes will lead to a better understanding of decision making. We share this view.