Miracle-dz/UniFAR-FTUs huggingface dataset:
Pathogenesis of sporadic and familial gastric cancer – implications for clinical management and cancer prevention

Gastric cancer remains a great clinical challenge despite its decreasing incidence. While major progress has been achieved in the understanding of the pathogenesis and molecular biology of sporadic gastric cancer, only recently has the role of familial aggregation of gastric cancers been rediscovered. The genetic changes underlying sporadic and familial gastric cancer have been revealed, and recent studies indicate that this familial aggregation combines genetic and microbiological aspects. Thus, for the prevention of gastric cancers these findings might be helpful for the early diagnosis and for the screening of risk groups and family members.
OC-011 Endoscopic therapy in barrett's oesophagus (be) with HGD (high grade dysplasia) and early malignancy; a prospective, single centre experience

Introduction There is increasing evidence that endoscopic therapy in BE with a combination of endoscopic mucosal resection (EMR) and radiofrequency ablation (RFA) is an effective treatment of intramucosal cancer (IMC) and HGD. The widespread application of this therapy is yet to be assessed in the UK outside the trial setting. We present here the results of a single centre study from a large tertiary referral teaching hospital. We aim to assess the efficacy and safety of endoscopic therapy with EMR and RFA in the treatment of HGD and IMC. Methods 102 consenting patients with a mean age of 69 (range 42–89) with HGD or IMC were enrolled between July 2008 and September 2011. All pathology was reviewed by a pathologist with a particular interest in Barrett's. The treatment protocol involved EMR of all nodular areas with subsequent RFA of all remaining Barretts epithelium. The RFA technique involved a combination of circumferential RFA (HALO 360) followed by subsequent focal ablation (HALO 90) of residual areas of Barrett's tongues or islands. The UK protocol involved a maximum of two HALO 360's and 3 HALO 90's. Results 102 patients have been recruited (30 with IMC and 72 with HGD). Fifty patients have completed the treatment protocol (median of 1 HALO 360 and 1 HALO 90) and of these, 52% had initial EMR. Median follow-up in this group was 9 months (range 3–41). Thirteen of these 50 patients had IMC (26%) with 37 patients demonstrating flat HGD only. Of the 102 patients recruited, nine patients (8.7%) have progressed to invasive malignancy after a median of 12 months. As a result, there were 59 patients who exited the protocol following an intention to treat. To date eradication of dysplasia was achieved in 49/59 patients (83%) and eradication of metaplasia in 40/59 patients (68%). Three patients died from unrelated causes, two from cardiorespiratory comorbidities and one from concurrent lymphoma. Eight patients (8%) developed mild strictures. One patient required readmission for retrosternal pain requiring analgesia. There were no serious complications or peri-procedural mortality. Conclusion This study demonstrates the efficacy of endotherapy with EMR and RFA in the treatment of IMC and HGD. Although further follow-up is required, these results suggest that such therapy should be offered to all patients as an alternative to surgery. Competing interests None declared.
Health effects of shift work and extended hours of work

“Normal” hours of work are generally taken to mean a working day with hours left for recreation and rest. Rest is a night time activity, work a daytime activity. This review is concerned with those who work other schedules either on shifts or with extended hours which transcend the day-night work-sleep pattern. Such abnormal” working hours are not a modern phenomenon. Ramazzini (1633–1714) noted that bakers, innkeepers, and soldiers worked such hours. The advent of the industrial revolution led to many people working long hours until legislation was introduced to curtail the worst vicissitudes of the new factory based economy. ### SHIFT SCHEDULES Today, about one in five workers in Europe are employed on shift work involving night work and over one in 20 work extended hours . Shift systems involve periods of 6–12 hours work at a time with the shift crews alternating on two, three, or four shifts in any 24 hour period. The traditional three shifts start at 0600, 1400, and 2200 hours but there are many variations on this. Some workers only work on the two day shifts, some only nights, while others rotate through all three shifts with variable degrees of speed of rotation and direction of rotation. Extended hours of work is generally accepted to mean working more than 48 hours a week. This can occur on either day work or shift work due to either a high number of hours worked per day or a higher number of days worked per week. #### Box 1: Summary of EC Working Time Directive
Blood transfusion in primary total hip and knee arthroplasty. Incidence, risk factors, and thirty-day complication rates.

BACKGROUND The aim of this study was to analyze NSQIP (National Surgical Quality Improvement Program) data to better understand the incidence, risk factors, and thirty-day complication rates associated with transfusions in primary total hip and knee arthroplasty. METHODS We identified 9362 total hip and 13,662 total knee arthroplasty procedures from the database and separated those in which any red blood-cell transfusion was performed within seventy-two hours after surgery from those with no transfusion. Patient demographics, comorbidities, preoperative laboratory values, intraoperative variables, and postoperative complications were compared between patients who received a transfusion and those who did not. Multivariate logistic regression was used to identify independent risk factors for receiving a transfusion as well as for associated postoperative complications (thirty-day incidences of infection, venous thromboembolism, and mortality). RESULTS The transfusion rate after total hip arthroplasty was 22.2%. Significant risk factors for receiving a transfusion were age (OR [odds ratio] per ten years = 10.1), preoperative anemia (OR = 3.6), female sex (OR = 2.0), BMI (body mass index) of <30 kg/m(2) (OR = 1.4), and ASA (American Society of Anesthesiologists) class of >2 (OR = 1.3). Multivariate logistic regression analysis indicated that adjusted odds of infection, venous thromboembolism, and mortality did not differ significantly between patients who received a transfusion and those who did not. The transfusion rate after total knee arthroplasty was 18.3%. Risk factors for receiving a transfusion were age (OR per ten years = 10.2), preoperative anemia (OR = 3.8), BMI of <30 kg/m(2) (OR = 1.4), female sex (OR = 1.3), and ASA class of >2 (OR = 1.3). Multivariate logistic regression indicated that a transfusion was significantly associated with mortality (OR = 2.7) but not with infection or venous thromboembolism. CONCLUSIONS We did not find a strong association between perioperative red blood-cell transfusion and thirty-day incidences of infection, venous thromboembolism, or mortality; however, the odds of mortality were higher in patients who received a transfusion during total knee arthroplasty. LEVEL OF EVIDENCE Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Comparative study of the treatment outcomes of osteoporotic compression fractures without neurologic injury using a rigid brace, a soft brace, and no brace: a prospective randomized controlled non-inferiority trial.

BACKGROUND The efficacy of brace application for the treatment of osteoporotic compression fractures remains unclear. The purpose of this study was to compare the treatment outcomes in patients with osteoporotic compression fractures with regard to whether the patients had no braces, rigid braces, or soft braces. METHODS We randomly assigned sixty patients with acute one-level osteoporotic compression fractures within three days of injury to the no-brace, soft-brace, and rigid-brace groups through 1:1:1 allocation. The primary outcome was the baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture. The non-inferior margin of the Oswestry Disability Index was set at an average of 10 points. RESULTS The baseline adjusted Oswestry Disability Index score at twelve weeks after compression fracture in the no-brace group was not inferior to that in the soft-brace or rigid-brace groups. The mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 37.83 points (95% confidence interval, 26.77 to 48.90 points) in the soft-brace group, with a difference of -1.88 points (95% confidence interval, -7.02 to 9.38 points) between the groups. Similarly, the mean adjusted Oswestry Disability Index score was 35.95 points (95% confidence interval, 25.42 to 46.47 points) in the no-brace group and 33.54 points (95% confidence interval, 23.79 to 43.29 points) in the rigid-brace group, with a difference of 2.41 points (95% confidence interval, -7.86 to 9.27 points) between the groups. During the follow-up assessment period, there was no significant difference among the groups for the overall Oswestry Disability Index scores (p = 0.260), visual analog scale for pain scores for back pain (p = 0.292), and anterior body compression ratios (p = 0.237). However, the Oswestry Disability Index scores and the visual analog scale scores for back pain significantly improved with time after the fractures (p < 0.001), and the body compression ratios significantly decreased with time in all three groups (p < 0.001). CONCLUSIONS The Oswestry Disability Index scores for the treatment of compression fractures without a brace were not inferior to those with soft or rigid braces. Moreover, the improvement in back pain and progression of anterior body compression were similar among the three groups. LEVEL OF EVIDENCE Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Establishing capacity in a patient with incomplete locked‐in syndrome

Patients with locked‐in syndrome may have retained mental capacity to make decisions about their care and it is important that healthcare professionals prioritise communication rehabilitation. Here, Sarah Carrington and Jonathan Birns describe how they established capacity in a patient with incomplete locked‐in syndrome and helped him to communicate his current wishes regarding his treatment.
A High-Performance Stand-Alone Solar PV Power System for LED Lighting

This paper presents new improvements and real result of a stand-alone photovoltaic power system for LED lighting that was developed previously. The actual system, during day, charges a lead acid battery using MPPT algorithm for power transfer optimization, and, during night, it supervises battery discharge and controls the current in the power LED array. The improvements are in hardware and software. The hardware was simplified using only one DC/DC converter and only one microcontroller making it more efficient. The system board uses an ATMEL ATTINY861V microcontroller, a single-ended primary inductance converter (SEPIC), and sensors to read input and output voltages and currents to control all system. The software improvements are made in the battery charging algorithm, battery discharging algorithm, and in current control of the power LED array adjusting the light intensity. Moreover, results are presented showing the balance of energy in a period of 24 hours: first results of the MPPT algorithm in bulk battery charge phase and then the over battery charge phase, both in a sunny day. The power LED current control results are also presented showing a very small error. It turns off at 00 : 00 at each day to reduce the waste of energy. Finally, the balance of energy is studied and presented to help the right projection of the PV power panel needed and the necessary battery capacity.
Operative Treatment of Lateral Ankle Instability

Chronic lateral ankle instability can occur in a subset of patients following ankle inversion sprains. Operative treatment to restore stability in the ankle and hindfoot and to prevent further degenerative changes may be indicated in cases in which nonoperative treatment has failed.Anatomical direct repair with use of native ligament remnants with or without reinforcement of the inferior retinaculum is the so-called gold standard operative strategy for the treatment of lateral ankle instability. The procedure has shown promising short and long-term outcomes. Candidates for the procedure have ligament remnants of sufficient quality that are amendable to direct repair.Anatomical reconstruction with use of autograft or allograft is reserved for patients with insufficient ligament remnants to fashion a direct repair, failed previous lateral ankle repair, high body mass index, or generalized ligamentous laxity. A wide variety of autografts have been described, each with potential advantages and disadvantages. These procedures can provide good-to-excellent short-term outcomes. However, there is no available information on their long-term clinical results.Non-anatomical lateral ligament reconstruction typically involves the use of the adjacent peroneal brevis tendon and has been applied in cases in which only poor-quality ligament remains. The procedure can provide good to excellent short-term outcomes, although reported long-term outcomes have differed among studies. The particular tendon used for the graft should be carefully considered given the potential alterations in the kinematics of the ankle and hindfoot.Arthroscopic ligament repair is becoming increasingly popular as it is minimally invasive. This procedure is restricted to patients who have good-quality ligament remnants. Good-to-excellent clinical outcomes have been reported after short and long-term follow-up, although a relatively high rate of complications—including nerve damage—has been reported following the procedure and therefore warrants further investigation before widespread adoption can be advocated.
Fetal Programming in Rheumatoid Arthritis

markdownabstract__Abstract__ Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory, autoimmune disease mainly affecting synovial tissues, which can lead to severe morbidity and progressive joint destruction resulting in deformations and disability. Other important outcomes include extra-articular features and comorbidities, like vasculitis, cardiac disease and infections. RA affects approximately 1% of the adult population and each year, 5 to 50 per 100.000 persons develop this condition. Women are affected two to three times more often than men. The age of onset in women is usually between 40 and 50 years, but it often affects women of childbearing age.
INSTANTANEOUS FEEDBACK PEDOMETER WITH EMERGENCY GPS TRACKER

Physical activity is closely related to one’s health status. Man has always maintained a good health, improved blood circulation and has often come across through some superlative ideas while ambulating. Movement, meditation, health of blood pumping and rhythm of footsteps has been a primeval way of connecting with one’s deeper self. However, this seldom explains the importance of walking and tracking our health parameters. This paper is an attempt in the development of a prototype of a wearable fitness band with advance pedometer applications. Usually, pedometers are just designed to calculate the number of steps taken by the user or calculate the number of calories burnt. The prototype illustrated in the paper is an extension to the very same. Along with the above mentioned features, it also calculates the walking speed of the user and gives a vibration feedback if the current speed is below a certain threshold level.This system also contains a heart rate monitoring system along with a GPS and Bluetooth module. An Android app was also developed using MIT app inventor. The Bluetooth module is paired with the user’s smart phone. If the user experiences a sudden cardiac emergency, an SMS alert and call is made to his relatives with the app. The text message consists the latitude and longitude value where user is present. This band is not just a fitness tracker, but also an effort to contribute something towards a humanitarian cause.
To be motivated or only comply – patients’ views of hypertension care after consultation training for nurses

Objective: This paper reports on patients’ perspectives on the nurse management of hypertension following consultation training, elicited as part of a randomised controlled study. Method: Telephone interviews were conducted with 16 patients in an intervention group (IG) and eight patients in a control group (CG), 3 years after nurses’ consultation training in primary health care. By means of a 3-day course, nurses were educated in patient centredness, Motivational Interviewing, the Stages of Change model, guidelines for cardiovascular prevention, lifestyle changes and pharmacological treatment. In addition, they took part in video-recorded consultation training with simulated patients. A specially designed educational booklet was developed for patients in the IG. Results: Of the 16 patients in the IG, 13 reported that their views and former experiences were taken into account and all eight patients in the CG reported the same. Patients in the IG reported that the nurse listened and they had been guided and motivated to perform lifestyle changes. The booklet in the IG was reported to have been read several times, but a few patients did not remember receiving it. There were more informed thoughts about how to manage lifestyle in the IG. Patients in the CG were less detailed in their descriptions. Conclusion: Patients in both IG and CG reported to have made efforts to change lifestyle, and patients in the IG reported that they had been coached and motivated by their nurses to do so.
Resolution of venous thrombus is depending on B-lymphocytes

Purpose: Splenectomy is associated with complex venous thromboembolism such as recurrent deep venous thrombosis, portal vein thrombosis, and chronic thromboembolic pulmonary hypertension (CTEPH). The spleen serves not only as a red blood cell filter but also as immunological organ. The aim of our study was to decipher the population of spleen cells responsible for misguided thrombus resolution after splenectomy. Methods: We utilized a mouse model of stagnant flow venous thrombosis to characterize thrombus resolution. Splenectomy was performed one month before vena cava ligation. In defined groups, whole spleens, spleens depleted of B-lymphocytes or B-lymphocytes alone were reinfused intraperitoneally. On days 3,7,14 and 28 after vena cava ligation thrombi were harvested for histology. Results: Thrombi of splenectomized mice were significantly larger than those of controls at all time points (ANOVA, n=8, p Discussion: Reinfusion of spleen cells restores normal venous thrombus resolution in a mouse model. Our data demonstrate that splenic B-lymphocytes play a key role in thrombus resolution.
On the Consequences of Mentally Simulating Future Foregone Outcomes: A Regret Regulation Perspective

When deciding what to do, we often think about the consequences of our actions and evaluate their attractiveness and likelihood of occurrence. Our choices are then at least partly based on these appraisals. However, when decisions are important enough, we also tend to think about how we would evaluate our outcomes in light of the outcomes forgone. This has sometimes been referred to as prefactual thinking (e.g., Sanna, 1996). For example, when choosing to invest all our savings in risky stocks, we may envision the situation that the stock market crashes and compare that outcome to the alternative in which our money would have been securely placed in a savings account. In turn, entertaining such prefactual thoughts arouses emotions. In this particular example, one could already feel the regret on learning that the savings account would have dramatically outperformed the stock market investment. This feeling of potential regret concerning future worlds is often contents
Fluids as oxygen carriers and the potential role in trauma resuscitation

Patients with major trauma present a challenge, often using large quantities of banked blood both at the time of injury and during their hospital stay. Blood transfusion is not without risk and is associated with high costs; it is immunosuppressive, rendering patients more susceptible to infection. In the western world, banked blood is fully screened and relatively safe; the same is not true in parts of the developing world, where high rates of HIV carriage make blood transfusion a risky undertaking. Additionally, blood transfusion as a vector for transmission of illnesses such as prion disease is a distinct possibility, for both the developed and developing world alike. The introduction of artificial blood substitutes would ameliorate some risk and also remove the cost of extensive blood testing. For trauma outside hospital, blood substitutes could compete directly with fluid resuscitation as donated blood is not usually available. Patients with prolonged transport times would appear to be the most obvious beneficiaries and volume expansion, along with improvement in oxygen-carrying capacity would be the ultimate goal. All clinicians confronted with the need for transfusion of homologous blood would welcome the development of a safe and reliable alternative to red blood cells in order to ensure oxygen transport to the tissues. However, even though research on red cell substitutes started more than 100 years ago, even now none of the heavily investigated compounds based on haemoglobin or perfluorocarbons has been released in Europe or the USA for routine clinical use.