Miracle-dz/UniFAR-FTUs huggingface dataset:
Monounsaturated Fat and Cardiovascular Risk

On the basis of the information discussed in this review, we can conclude that the effects of a high intake of monounsaturated fatty acids (MUFA) from olive oil include a wide range of healthy benefits beyond improvement in cholesterol levels, suggesting that this type of diet has great potential in preventing cardiovascular disease. MUFA-enriched diets reduce insulin requirements and decrease plasma concentrations of glucose and insulin in type 2 diabetic patients, unlike high-saturated fatty acid and low-fat, high-carbohydrate diets. Moreover, some data show that this dietary model could have a hypotensive effect. There is also substantial evidence that oleic-enriched low-density lipoprotein (LDL) is more resistant to oxidative modifications and that dietary MUFA may influence various components and functions related to the endothelium. These include endothelium-dependent vasodilatation and a reduced capacity of oleicenriched LDL to promote the adhesion and chemotaxis of monocytes. On the other hand, a MUFA diet decreases the prothrombotic environment, modifying platelet adhesion, coagulation, and fibrinolysis. Its reducing effect on PAI-1 plasma levels is of particular relevance. This wide range of anti-atherogenic effects could explain the low rate of cardiovascular mortality found in Mediterranean countries, where there is a moderate to high supply of dietary MUFA. Future studies need to focus on uncovering the mechanisms by which the Mediterranean diet exerts its beneficial effects
Evaluation of the hormones responsible for the gastrointestinal motility in cattle with displacement of the abomasum; ghrelin, motilin and gastrin

This study provides the evidence of increased serum gastrointestinal motility hormone concentrations including ghrelin, motilin and gastrin in cattle with displacement of abomasum (DA). In this study, 38 cows with DA (21 left DA (LDA) and 17 right DA (RDA)) and 15 healthy controls were included. All cattle with DA were at the stage of postpartum one to eight weeks, and had clinical signs including anorexia, decreased milk yield and scanty, pasty faeces. Serum ghrelin, motilin and gastrin concentrations, and leptin concentration which is a functional antagonist of ghrelin, were determined by ELISA. Serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), Na, K, Cl, Ca and P concentrations were measured by spectrophotometer. In serum biochemical analysis, increases were seen on the serum ALT, AST and GGT activities; however, serum Na, K, Cl and P concentrations decreased in abomasal displacement compared with the control animals. The serum ghrelin, motilin and gastrin concentrations increased in the cattle with LDA and RDA, as compared with those in the healthy controls. On the other hand, serum leptin concentration decreased in the cattle with DA compared with the controls. Increases in the serum ghrelin, motilin and gastrin concentrations might be attributed to activation of gastrointestinal motility hormones to enhance of gastric emptying in impaired gastric motility and/or outlet occlusion in displaced abomasum.
Cognitive function after the initiation of adjuvant endocrine therapy in early-stage breast cancer: an observational cohort study.

PURPOSE This report examines cognitive complaints and neuropsychological (NP) testing outcomes in patients with early-stage breast cancer after the initiation of endocrine therapy (ET) to determine whether this therapy plays any role in post-treatment cognitive complaints. PATIENTS AND METHODS One hundred seventy-three participants from the Mind Body Study (MBS) observational cohort provided data from self-report questionnaires and NP testing obtained at enrollment (T1, before initiation of ET), and 6 months later (T2). Bivariate analyses compared demographic and treatment variables, cognitive complaints, depressive symptoms, quality of life, and NP functioning between those who received ET versus not. Multivariable linear regression models examined predictors of cognitive complaints at T2, including selected demographic variables, depressive symptoms, ET use, and other medical variables, along with NP domains that were identified in bivariate analyses. RESULTS Seventy percent of the 173 MBS participants initiated ET, evenly distributed between tamoxifen or aromatase inhibitors. ET-treated participants reported significantly increased language and communication (LC) cognitive complaints at T2 (P = .003), but no significant differences in NP test performance. Multivariable regression on LC at T2 found higher LC complaints significantly associated with T1 LC score (P < .001), ET at T2 (P = .004), interaction between ET and past hormone therapy (HT) (P < .001), and diminished improvement in NP psychomotor function (P = .05). Depressive symptoms were not significant (P = .10). CONCLUSION Higher LC complaints are significantly associated with ET 6 months after starting treatment and reflect diminished improvements in some NP tests. Past HT is a significant predictor of higher LC complaints after initiation of ET.
Diagnostic criteria for the classification of cancer-associated weight loss.

PURPOSE Existing definitions of clinically important weight loss (WL) in patients with cancer are unclear and heterogeneous and do not consider current trends toward obesity. METHODS Canadian and European patients with cancer (n = 8,160) formed a population-based data set. Body mass index (BMI) and percent WL (%WL) were recorded, and patients were observed prospectively until death. Data were entered into a multivariable analysis controlling for age, sex, cancer site, stage, and performance status. Relationships for BMI and %WL to overall survival were examined to develop a grading system. RESULTS Mean overall %WL was -9.7% ± 8.4% and BMI was 24.4 ± 5.1 kg/m(2), and both %WL and BMI independently predicted survival (P < .01). Differences in survival were observed across five categories of BMI (< 20.0, 20.0 to 21.9, 22.0 to 24.9, 25.0 to 27.9, and ≥ 28.0 kg/m(2); P < . 001) and five categories of %WL (-2.5% to -5.9%, -6.0% to -10.9%, -11.0% to -14.9%, ≥ -15.0%, and weight stable (± 2.4%); P < . 001). A 5 × 5 matrix representing the five %WL categories within each of the five BMI categories was graded based on median survival and prognostic significance. Weight-stable patients with BMI ≥ 25.0 kg/m(2) (grade 0) had the longest survival (20.9 months; 95% CI, 17.9 to 23.9 months), and %WL values associated with lowered categories of BMI were related to shorter survival (P < .001), as follows: grade 1, 14.6 months (95% CI, 12.9 to 16.2 months); grade 2, 10.8 months (95% CI, 9.7 to 11.9 months); grade 3, 7.6 months (95% CI, 7.0 to 8.2 months); and grade 4, 4.3 months (95% CI, 4.1 to 4.6 months). Survival discrimination by grade was observed within specific cancers, stages, ages, and performance status and in an independent validation sample (n = 2,963). CONCLUSION A robust grading system incorporating the independent prognostic significance of both BMI and %WL was developed.
Fungal airsacculitis associated with serratospiculiasis in captive falcons of the United Arab Emirates

Serratospiculum is a filarial nematode responsible for the parasitic disease serratospiculiasis. There are nine species of Serratospiculum recognised with cosmopolitan distribution, but S seurati is the only species identified in the Middle East (Samour and Silvanose 2000, Samour and Naldo 2001, Tarello 2006, Al Timimi and others 2009). The worm infects the air sac of carnivore birds, and has been reported in Falconiformes and Accipiters (Ackernam 1992, Bigland 1964, Sterner 1988, Wehr 1938). S seurati is transmitted by ingestion of infected insects, usually beetles and wood louse. After ingestion, the larvae penetrate the wall of the proventriculus and ventriculus, then migrate into the air sac system where they mature to become adult filarial worms. Identification of the parasite is made through faecal examination, crop cytology and endoscopy of the air sacs. Adult worms can damage the air sac membrane and cause degenerative changes within the collagen and the muscle layers between the epithelial and mesothelial component of the air sac (Mauriz and Sterner 2008). In captive falcons, the infection can contribute to stress-induced lower respiratory disease syndromes, and S seurati has been associated with bacterial and fungal pneumonia and airsacculitis (Samour and Naldo 2001). In …
Risk Factors of Dyslipidemia in Hypertensive Patients in Selected Urban and Rural Areas inIndonesia

Risk Factors of Dyslipidemia in Hypertensive Patients in Selected Urban and Rural Areas in Indonesia Currently, Indonesia is in epidemiology transition regarding the burden of infectious diseases, as well as the threat of noncommunicable diseases. The main risk factors of developing cardiovascular disease are smoking habit, hypertension and dyslipidemia; the latter two often occurring simultaneously. The purpose of this study was to obtain a predictive model of the occurrence of dyslipidemia in hypertensive patients. Study design was a cross sectional study. The selection of samples was �simple random sampling� based on the medical records of hypertensive patients. The results showed that 47.6% of patients with hypertension manifest dyslipidemia (39.2% rural and 59.3% urban areas). Risk factors of dyslipidemia in hypertensive patient in urban areas was working status after controlled by BMI (Body Mass Index), and fat intake, while in rural areas was gender after controlled by fat intake, and fried food consumption.
Laparoscopy or open surgery for colorectal cancer within an enhanced recovery program?

TO THE EDITOR: Kennedy et al recently published an article examining the postoperative outcomes of laparoscopic surgery versus open resection of colorectal cancer within an enhanced recovery program (ERP). The main finding of their trial, called EnROL (Enhanced Recovery Open Versus Laparoscopic), was that laparoscopic surgery reduced the total postoperative hospital stay by 2 days. We congratulate the authors for their efforts because we know the difficulties of conducting such a trial. However, we think that some limitations of the study should be addressed. First, we noticed that compliance with the ERP components was low, especially with respect to early oral feeding, early mobilization, and optimized analgesia. Early oral feeding has been proven to reduce the length of hospital stay and the total postoperative complications. Failure to mobilize has been associated with prolonged length of hospital stay. In addition, Vlug et al found that hospital stay was reduced by 28% when early oral feeding and early mobilization were achieved. Optimized pain relief, allowing early mobilization and early return of gut function, is a prerequisite for enhanced recovery. Strict adherence to the ERP was associated with reduced length of hospital stay and improved outcome in colonic surgery for malignancy. Thus, the low compliance with the ERP components may have introduced a high risk of bias to the EnROL trial. Second, it was reported that the greater the number of evidencebased components included in the ERP, the better the outcome. However, some key ERP items were not included in the EnROL trial, such as prevention of postoperative nausea and vomiting. Postoperative nausea and vomiting lead to intolerance to oral feeding and is a leading cause of patient dissatisfaction and delayed hospital discharge. The absence of this ERP item probably explains the low compliance with early oral feeding. Above all, the low compliance and the absence of some key ERP components might make the EnROL trial underpowered, despite the substantial work of the authors. Therefore, the question regarding the benefits of laparoscopy within an ERP was not adequately answered by the EnROL trial. Additional large-scale randomized clinical trials are needed to examine the benefits of laparoscopic colorectal resection in the context of an even more optimized ERP than that applied in the EnROL trial.
Age-dependent changes in health status in the Childhood Cancer Survivor cohort.

PURPOSE To compare age-dependent changes in health status among childhood cancer survivors and a sibling cohort. METHODS Adult survivors of childhood cancer and siblings, all participants of the Childhood Cancer Survivor Study, completed three surveys assessing health status. At each of three time points, participants were classified as having poor outcomes in general health, mental health, function, or daily activities if they indicated moderate to extreme impairment. Generalized linear mixed models were used to compare survivors with siblings for each outcome as a function of age and to identify host- and treatment-related factors associated with age-dependent worsening health status. RESULTS Adverse health status outcomes were more frequent among survivors than siblings, with evidence of a steeper trajectory of age-dependent change among female survivors with impairment in at least one health status domain (P = .01). In adjusted models, survivors were more likely than siblings to report poor general health (prevalence ratio [PR], 2.37; 95% CI, 2.09 to 2.68), adverse mental health (PR, 1.66; 95% CI, 1.52 to 1.80), functional impairment (PR, 4.53; 95% CI, 3.91 to 5.24), activity limitations (PR, 2.38; 95% CI, 2.12 to 2.67), and an adverse health status outcome in any domain (PR, 2.10; 95% CI, 1.97 to 2.23). Cancer treatment and health behaviors influence the magnitude of differences by age groups. Chronic conditions were associated with adverse health status outcomes across organ systems. CONCLUSION The prevalence of poor health status is higher among survivors than siblings, increases rapidly with age, particularly among female participants, and is related to an increasing burden of chronic health conditions.
L‐citrulline provides a novel strategy for treating chronic pulmonary hypertension in newborn infants

Effective therapies are urgently needed for infants with forms of pulmonary hypertension that develop or persist beyond the first week of life. The L‐arginine nitric oxide (NO) precursor, L‐citrulline, improves NO signalling and ameliorates pulmonary hypertension in newborn animals. In vitro studies demonstrate that manipulating L‐citrulline transport alters NO production.
RTOG 9804: a prospective randomized trial for good-risk ductal carcinoma in situ comparing radiotherapy with observation.

PURPOSE The Radiation Therapy Oncology Group 9804 study identified good-risk patients with ductal carcinoma in situ (DCIS), a breast cancer diagnosis found frequently in mammographically detected cancers, to test the benefit of radiotherapy (RT) after breast-conserving surgery compared with observation. PATIENTS AND METHODS This prospective randomized trial (1998 to 2006) in women with mammographically detected low- or intermediate-grade DCIS, measuring less than 2.5 cm with margins ≥ 3 mm, compared RT with observation after surgery. The study was designed for 1,790 patients but was closed early because of lower than projected accrual. Six hundred thirty-six patients from the United States and Canada were entered; tamoxifen use (62%) was optional. Ipsilateral local failure (LF) was the primary end point; LF and contralateral failure were estimated using cumulative incidence, and overall and disease-free survival were estimated using the Kaplan-Meier method. RESULTS Median follow-up time was 7.17 years (range, 0.01 to 11.33 years). Two LFs occurred in the RT arm, and 19 occurred in the observation arm. At 7 years, the LF rate was 0.9% (95% CI, 0.0% to 2.2%) in the RT arm versus 6.7% (95% CI, 3.2% to 9.6%) in the observation arm (hazard ratio, 0.11; 95% CI, 0.03 to 0.47; P < .001). Grade 1 to 2 acute toxicities occurred in 30% and 76% of patients in the observation and RT arms, respectively; grade 3 or 4 toxicities occurred in 4.0% and 4.2% of patients, respectively. Late RT toxicity was grade 1 in 30%, grade 2 in 4.6%, and grade 3 in 0.7% of patients. CONCLUSION In this good-risk subset of patients with DCIS, with a median follow-up of 7 years, the LF rate was low with observation but was decreased significantly with the addition of RT. Longer follow-up is planned because the timeline for LF in this setting seems protracted.
Spontaneous preterm labour and delivery at under 34 weeks' gestation

The authors also make two unjustified conclusions. Firstly, they suggest that response does not influence survival. This is contrary to their own results. "The median survival time was longer than 41 months for patients with a partial remission, less than seven months for those with progressive disease, and 23 and 21 months respectively for patients with a minor response and no change (partial remission v minor response+no change v progressive disease: p< 0-0001). " The correlation between survival and response has been reported by others.2 Finally, the authors state that cytotoxic drugs in older patients can have unpleasant side effects. Unpleasant side effects are an expected (if unwelcome) concomitant of cytotoxic chemotherapy in patients of all ages. Begg et al, in a retrospective analysis of patients treated in studies of the Eastern Cooperative Oncology Group, showed that older patients did not appear to be unduly susceptible to cytotoxic toxicity.6
Crizotinib therapy for advanced lung adenocarcinoma and a ROS1 rearrangement: results from the EUROS1 cohort.

PURPOSE Approximately 1% of lung adenocarcinomas are driven by oncogenic ROS1 rearrangement. Crizotinib is a potent inhibitor of both ROS1 and ALK kinase domains. PATIENTS AND METHODS In the absence of a prospective clinical trial in Europe, we conducted a retrospective study in centers that tested for ROS1 rearrangement. Eligible patients had stage IV lung adenocarcinoma, had ROS1 rearrangement according to fluorescent in situ hybridization, and had received crizotinib therapy through an individual off-label use. Best response was assessed locally using RECIST (version 1.1). All other data were analyzed centrally. RESULTS We identified 32 eligible patients. One patient was excluded because next-generation sequencing was negative for ROS1 fusion. Median age was 50.5 years, 64.5% of patients were women, and 67.7% were never-smokers. Thirty patients were evaluable for progression-free survival (PFS), and 29 patients were evaluable for best response. We observed four patients with disease progression, two patients with stable disease, and objective response in 24 patients, including five complete responses (overall response rate, 80%; disease control rate, 86.7%). Median PFS was 9.1 months, and the PFS rate at 12 months was 44%. No unexpected adverse effects were observed. Twenty-six patients received pemetrexed (either alone or in combination with platinum and either before or after crizotinib) and had a response rate of 57.7% and a median PFS of 7.2 months. CONCLUSION Crizotinib was highly active at treating lung cancer in patients with a ROS1 rearrangement, suggesting that patients with lung adenocarcinomas should be tested for ROS1. Prospective clinical trials with crizotinib and other ROS1 inhibitors are ongoing or planned.
Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer.

PURPOSE The use of multiple and/or inappropriate medications in seniors is a significant public health problem, and cancer treatment escalates its prevalence and complexity. Existing studies are limited by patient self-report and medical record extraction compared with a pharmacist-led comprehensive medication assessment. PATIENTS AND METHODS We retrospectively examined medication use in ambulatory senior adults with cancer to determine the prevalence of polypharmacy (PP) and potentially inappropriate medication (PIM) use and associated factors. PP was defined as concurrent use of five or more and less than 10 medications, and excessive polypharmacy (EPP) was defined as 10 or more medications. PIMs were categorized by 2012 Beers Criteria, Screening Tool of Older Person's Prescriptions (STOPP), and the Healthcare Effectiveness Data and Information Set (HEDIS). RESULTS A total of 248 patients received a geriatric oncology assessment between January 2011 and June 2013 (mean age was 79.9 years, 64% were women, 74% were white, and 87% had solid tumors). Only 234 patients (evaluated by pharmacists) were included in the final analysis. Mean number of medications used was 9.23. The prevalence of PP, EPP, and PIM use was 41% (n = 96), 43% (n = 101), and 51% (n = 119), respectively. 2012 Beers, STOPP, and HEDIS criteria classified 173 occurrences of PIMs, which were present in 40%, 38%, and 21% of patients, respectively. Associations with PIM use were PP (P < .001) and increased comorbidities (P = .005). CONCLUSION A pharmacist-led comprehensive medication assessment demonstrated a high prevalence of PP, EPP, and PIM use. Medication assessments that integrate both 2012 Beers and STOPP criteria and consider cancer diagnosis, prognosis, and cancer-related therapy are needed to optimize medication use in this population.
Clinical Course of Oxaliplatin-Induced Neuropathy: Results From the Randomized Phase III Trial N08CB (Alliance).

PURPOSE Given that the clinical course of oxaliplatin-induced neuropathy is not well defined, the current study was performed to better understand clinical parameters associated with its presentation. METHODS Acute and chronic neuropathy was evaluated in patients receiving adjuvant FOLFOX (fluorouracil, leucovorin, and oxaliplatin) on study N08CB (North Central Cancer Treatment Group, Alliance). Acute neuropathy was assessed by having patients complete daily questionnaires for 6 days with each cycle of FOLFOX. Before each dose of FOLFOX and as long as 18 months after chemotherapy cessation, chronic neurotoxicity was assessed with use of the 20-item, European Organisation for Research and Treatment of Cancer quality-of-life questionnaire for patients with chemotherapy-induced peripheral neuropathy. RESULTS Three hundred eight (89%) of the 346 patients had at least one symptom of acute neuropathy with the first cycle of FOLFOX; these symptoms included sensitivity to touching cold items (71%), sensitivity to swallowing cold items (71%), throat discomfort (63%), or muscle cramps (42%). Acute symptoms peaked at day 3 and improved, although they did not always resolve completely between treatments. These symptoms were about twice as severe in cycles 2 through 12 as they were in cycle 1. For chronic neurotoxicity, tingling was the most severe symptom, followed by numbness and then pain. During chemotherapy, symptoms in the hands were more prominent than they were in the feet; by 18 months, symptoms were more severe in the feet than they were in the hands. Patients with more severe acute neuropathy during the first cycle of therapy experienced more chronic sensory neurotoxicity (P < .0001). CONCLUSION Acute oxaliplatin-induced neuropathy symptoms do not always completely resolve between treatment cycles and are only half as severe on the first cycle as compared with subsequent cycles. There is a correlation between the severities of acute and chronic neuropathies.