Miracle-dz/UniFAR-FTUs huggingface dataset:
Polysomy 17 and HER-2 amplification: true, true, and unrelated.

Approximately 25% of breast cancers overexpress the human epidermal growth factor receptor 2 (HER-2) protein, usually as a result of high copy number of its gene (amplification) on chromosome 17q12-21. HER-2 signaling promotes cell proliferation, and overexpression or gene amplification are associated with poor prognosis. 1 Inviewofthis,trastuzumab(Herceptin;Genentech,SouthSan Francisco, CA), a humanized monoclonal immunoglobulin G antibody, was developed to specifically target the extracellular domain of HER-2. 2 Becausetrastuzumabisbotheffectiveandtoxicinsomepatients, identifyingpatientswhowillbenefitisofgreatimportance.Currently, patient selection is based on the determination of HER-2 status, because trastuzumab is expected to be effective only against HER-2‐ positive breast cancers. The definition of HER-2 positive has evolved over time, and guidelines to standardize testing and interpretation havebeenproposed. 3,4 Evenwithsuchguidelines,patientselectionfor
Omega-3 fatty acids: a comprehensive review of their role in health and disease

Omega-3 fatty acids (ω-3 FAs) are essential fatty acids with diverse biological effects in human health and disease. Reduced cardiovascular morbidity and mortality is a well-established benefit of their intake. Dietary supplementation may also benefit patients with dyslipidaemia, atherosclerosis, hypertension, diabetes mellitus, metabolic syndrome, obesity, inflammatory diseases, neurological/ neuropsychiatric disorders and eye diseases. Consumption of ω-3 FAs during pregnancy reduces the risk of premature birth and improves intellectual development of the fetus. Fish, fish oils and some vegetable oils are rich sources of ω-3 FAs. According to the UK Scientific Advisory Committee on Nutrition guidelines (2004), a healthy adult should consume a minimum of two portions of fish a week to obtain the health benefit. This review outlines the health implications, dietary sources, deficiency states and recommended allowances of ω-3 FAs in relation to human nutrition.
Production Rules for Stereo Acquisition

This paper gives an overview on the framework of production rules that are required for the acquisition of adequate stereo content. It is well known that if stereo is not produced properly, consequences for the human 3-D perception might be eye strain and visual fatigue. Therefore, to avoid discomfort, stereographers use a production grammar that reflects extensive knowledge and experience in the fields of 3-D perception, stereo geometry, video technology, and content creation. Some of these rules are of heuristic nature, and others are motivated by perceptual, geometric, or technical aspects. The application of these rules at the set usually results in time-consuming manual work for rigging and adjusting stereo cameras before shooting. Against this background the paper reviews relevant aspects of 3-D perception, the fundamentals of stereo geometry, and the main rules of stereo production. Finally, it describes the functionality of camera assistance systems that have recently been proposed for stereo acquisition and production in order to ease the work of stereographers at the set and, with it, to save time and to make stereo productions more efficient.
Biologic cost of caring for a cancer patient: dysregulation of pro- and anti-inflammatory signaling pathways.

PURPOSE Caring for a family member with cancer is a psychologically demanding experience. However, it remains unclear whether the distress that caregiving provokes also takes a physiologic toll on the body. This study observed familial caregivers of patients with brain cancer for a year after diagnosis and tracked changes in neurohormonal and inflammatory processes. PATIENTS AND METHODS Eighteen caregivers (age 50.4 +/- 3.5 years) and 19 controls (age 50.2 +/- 2.6 years) were assessed four times during a year (before and after radiotherapy, as well as 6 weeks and 4 months thereafter). Salivary biomarkers of hypothalamus-pituitary-adrenal axis and sympathetic nervous system (SNS) activity were collected, and blood was drawn for assessment of the systemic inflammatory markers C-reactive protein (CRP) and interleukin-6 (IL-6). Blood was also used to monitor in vitro IL-6 production by endotoxin-stimulated leukocytes and expression of mRNA for pro- and anti-inflammatory signaling molecules. RESULTS Caregivers showed marked changes over time in diurnal output of salivary amylase, a marker of SNS activity, whereas secretions in controls were stable during follow-up. Cortisol output was similar in caregivers and controls. During the year, caregivers showed a profound linear increase in systemic inflammation, as indexed by CRP. At the same time, they displayed a linear decline in mRNA for anti-inflammatory signaling molecules and diminished in vitro glucocorticoid sensitivity. CONCLUSION These preliminary data show that familial caregivers of patients with cancer experience marked changes in neurohormonal and inflammatory processes in the year after diagnosis. These changes may place them at risk for morbidity and mortality from diseases fostered by excessive inflammation.
Capacity Trends and Limits of Optical Communication Networks

Since the first deployments of fiber-optic communication systems three decades ago, the capacity carried by a single-mode optical fiber has increased by a staggering 10 000 times. Most of the growth occurred in the first two decades with growth slowing to ten times in the last decade. Over the same three decades, network traffic has increased by a much smaller factor of 100, but with most of the growth occurring in the last few years, when data started dominating network traffic. At the current growth rate, the next factor of 100 in network traffic growth will occur within a decade. The large difference in growth rates between the delivered fiber capacity and the traffic demand is expected to create a capacity shortage within a decade. The first part of the paper recounts the history of traffic and capacity growth and extrapolations for the future. The second part looks into the technological challenges of growing the capacity of single-mode fibers by presenting a capacity limit estimate of standard and advanced single-mode optical fibers. The third part presents elementary capacity considerations for transmission over multiple transmission modes and how it compares to a single-mode transmission. Finally, the last part of the paper discusses fibers supporting multiple spatial modes, including multimode and multicore fibers, and the role of digital processing techniques. Spatial multiplexing in fibers is expected to enable system capacity growth to match traffic growth in the next decades.
Wavelength-Selective Reconfiguration in Transparent Agile Optical Networks

The development of wavelength-selective switching (WSS) technologies is enabling the next generation of transparent optical networks, with remote reconfiguration of the mesh network providing optimal network utilization. Whereas first generations of networks were based on the ITU-defined fixed 50/100-GHz grids, true spectral transparency becomes possible with the introduction of Flexible Grid (FG) wavelength switching within the mesh network. Optical architectures that support the addition and dropping at any node of bandwidth-variable channels will allow optimal spectral utilization in transmission of legacy and next-generation transmission formats.
Outcome of deferred initial therapy in mantle-cell lymphoma.

PURPOSE Treatment of mantle-cell lymphoma (MCL) is nonstandardized, though patients are commonly treated immediately at diagnosis. Because data on observation, or "watch and wait," have not been previously reported, we analyzed the outcome of deferred initial therapy. PATIENTS AND METHODS Inclusion criteria in this retrospective analysis were a diagnosis of MCL between 1997 and 2007 and known date of first treatment. Hospital and research charts were reviewed for prognostic and treatment-related information. Date of death was derived from hospital records and confirmed using an online Social Security death index. RESULTS Of 97 patients with MCL evaluated at Weill Cornell Medical Center, 31 patients (32%) were observed for more than 3 months before initial systemic therapy, with median time to treatment for the observation group of 12 months (range, 4 to 128 months). The observation group (median follow-up, 55 months) had a median age of 58 years (range, 40 to 81 years). Prognostic factors in assessable patients included advanced stage (III/IV) in 75%, elevated lactate dehydrogenase in 25%, and intermediate- or high-risk Mantle Cell International Prognostic Index in 54%. Better performance status and lower-risk standard International Prognostic Index scores were more commonly present in those undergoing observation. Although time to treatment did not predict overall survival in a multivariate analysis, the survival profile of the observation group was statistically superior to that of the early treatment group (not reached v 64 months, P = .004). CONCLUSION In selected asymptomatic patients with MCL, deferred initial treatment ("watch and wait") is an acceptable management approach.
Complete cytoreductive surgery plus intraperitoneal chemohyperthermia with oxaliplatin for peritoneal carcinomatosis of colorectal origin.

PURPOSE To compare the long-term survival of patients with isolated and resectable peritoneal carcinomatosis (PC) in comparable groups of patients treated with systemic chemotherapy containing oxaliplatin or irinotecan or by cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC). PATIENTS AND METHODS All patients with gross PC from colorectal adenocarcinoma who had undergone cytoreductive surgery plus HIPEC from 1998 to 2003 were evaluated. The standard group was constituted by selecting patients with colorectal PC treated with palliative chemotherapy during the same period, but who had not benefited from HIPEC because the technique was unavailable in the center at that time. RESULTS Forty-eight patients were retrospectively included in the standard group and were compared with 48 patients who had undergone HIPEC and were evaluated prospectively. All characteristics were comparable except age and tumor differentiation. There was no difference in systemic chemotherapy, with a mean of 2.3 lines per patient. Median follow-up was 95.7 months in the standard group versus 63 months in the HIPEC group. Two-year and 5-year overall survival rates were 81% and 51% for the HIPEC group, respectively, and 65% and 13% for the standard group, respectively. Median survival was 23.9 months in the standard group versus 62.7 months in the HIPEC group (P < .05, log-rank test). CONCLUSION Patients with isolated, resectable PC achieve a median survival of 24 months with modern chemotherapies, but only surgical cytoreduction plus HIPEC is able to prolong median survival to roughly 63 months, with a 5-year survival rate of 51%.
A82: Lyme Arthritis: an Emerging Clinical Problem in Nova Scotia, Canada

Lyme disease (LD) is an emerging problem in the Canadian province of Nova Scotia with a sharp rise in reported cases over the past 2 years, including cases referred to the pediatric rheumatology clinic in Halifax, the sole pediatric rheumatology referral centre in the province. This increase is likely related to an increase in the number and size of endemic areas in the province; it is expected that cases will continue to rise. We sought to characterize the demographics, clinical presentation, treatment course and musculoskeletal outcome of children with LD in our clinic.
Inadvertent prescription of gelatin-containing oral medication: its acceptability to patients

When prescribing, doctors usually only consider the ‘active’ component of any drug's formulation ignoring the majority of the agents which make up the bulk of the tablet or capsule, collectively known as excipients. Many urological drugs contain the excipient gelatin which is, universally, of animal origin; this may conflict with the dietetic ideals of patients. A questionnaire-based study, undertaken between January and June 2010 in a mixed ethnicity inner-city population presenting with urological symptoms, asked which patients preferred not to ingest animal-based products, who would ask about the content of their prescribed treatment and who would refuse to take that medication if alternatives were available. Ultimately, the authors sought to find out how many patients had been inadvertently prescribed gelatin-containing oral medications and to suggest ways in which prescriptions might be more congruous with an individual patient's dietetic wishes. This study demonstrated that 43.2% of the study population would prefer not to take animal product-containing medication even if no alternative were available. 51% of men with lower urinary tract symptoms were also found to have inadvertently been prescribed gelatin-containing products against their preferred dietary restriction. Education of healthcare professionals about excipients and getting them to ask about a patient's dietetic preferences may help avoid inadvertent prescription of the excipient gelatin in oral medications. Substitution of gelatin with vegetable-based alternatives and clearer labelling on drug packaging are alternative strategies to help minimise the risks of inadvertently contravening a patient's dietetic beliefs when prescribing oral medication.
Functional gastrointestinal disorders

Complementary and Alternative Medicine (CAM), which includes Acupuncture, Herb, Shiatsu, Massage, Yoga and some others, is gett ing more common and common in the United States. Acupuncture is an empirical medical procedure that has been practiced in Japan and China for thousands of years and has been rapidly accepted throughout Western countries, including the United States. In November 1997, NIH held a consensus conference regarding acupuncture and issued a statement that acupuncture is eff ective for treating nausea and vomiting associated with postoperative and chemotherapy (N.I.O. Health 1997, Morey 1998). Acupuncture has been used for treating functional gastrointestinal (GI) disorders, including irritable bowel syndrome (IBS) and functional dyspepsia (FD) (Diehl 1999, Takahashi 2006). It is conceivable that acupuncture is eff ective in patients with functional GI disorders because it has been shown to alter acid secretion, GI motility and visceral pain. However, the precise mechanism of acupuncture on GI function remains to be clarifi ed. Effects of acupuncture on gastric functions II. of normal rats and dogs
Who makes prescribing decisions in hospital inpatients? An observational study

Purpose of the study Errors involving drug prescriptions are a key target for patient safety initiatives. Recent studies have focused on error rates across different grades of doctors in order to target interventions. However, many prescriptions are not instigated by the doctor who writes them. It is important to clarify how often this occurs in order to interpret these studies and create interventions. This study aimed to provisionally quantify and describe prescriptions where the identity of the decision maker and prescription writer differed. Design of the study Observational data was collected in six wards, 2 weeks per ward, at a single large UK teaching hospital over a 12-week period from January to April 2011. Results In 112/183 (61%) cases where a new medicine was prescribed, the decision maker was not the prescription writer. Conclusions Decision making and the writing of prescriptions are generally not undertaken by the same doctor. Moreover, communication about prescriptions is poor. Further research in a larger sample of hospitals is required to confirm generalisability of the results, and to inform educational interventions to reduce error rates.
Multicenter phase II trial of neoadjuvant pemetrexed plus cisplatin followed by extrapleural pneumonectomy and radiation for malignant pleural mesothelioma.

PURPOSE Neoadjuvant pemetrexed plus cisplatin was administered, followed by extrapleural pneumonectomy (EPP) and hemithoracic radiation (RT), to assess the feasibility and efficacy of trimodality therapy in stage I to III malignant pleural mesothelioma. PATIENTS AND METHODS Requirements included stage T1-3 N0-2 disease, no prior surgical resection, adequate organ function (including predicted postoperative forced expiratory volume in 1 second > or = 35%), and performance status 0 to 1. Patients received pemetrexed 500 mg/m(2) plus cisplatin 75 mg/m(2) for four cycles. Patients without disease progression underwent EPP followed by RT (54 Gy). The primary end point was pathologic complete response (pCR) rate. RESULTS Seventy-seven patients received chemotherapy. All four cycles were administered to 83% of patients. The radiologic response rate was 32.5% (95% CI, 22.2 to 44.1). Fifty-seven patients proceeded to EPP, which was completed in 54 patients. Three pCRs were observed (5% of EPP). Forty of 44 patients completed irradiation. Median survival in the overall population was 16.8 months (95% CI, 13.6 to 23.2 months; censorship, 33.8%). Patients completing all therapy had a median survival of 29.1 months and a 2-year survival rate of 61.2%. Radiologic response of complete or partial response was associated with a median survival of 26.0 months compared with 13.9 months for patients with stable disease or progressive disease (P = .05). CONCLUSION This multicenter trial showed that trimodality therapy with neoadjuvant pemetrexed plus cisplatin is feasible with a reasonable long-term survival rate, particularly for patients who completed all therapy. Radiologic response to chemotherapy, but not sex, histology, disease stage, or nodal status, was associated with improved survival.
Audit of the association between length of time spent on diagnostic work‐up and tumour stage in patients with symptomatic colon cancer

Colorectal cancer is one of the most incident cancers in New Zealand. Due to resource limitations, some patients experienced protracted wait times before reaching a definitive diagnosis. We analysed the relationship between time to diagnosis and clinical stage and reviewed the length of time for components of the diagnostic work‐up to identify priority areas for service improvement. We benchmarked our timeliness against introduced standards.
Phase III study to evaluate temsirolimus compared with investigator's choice therapy for the treatment of relapsed or refractory mantle cell lymphoma.

PURPOSE Temsirolimus, a specific inhibitor of the mammalian target of rapamycin kinase, has shown clinical activity in mantle cell lymphoma (MCL). We evaluated two dose regimens of temsirolimus in comparison with investigator's choice single-agent therapy in relapsed or refractory disease. PATIENTS AND METHODS In this multicenter, open-label, phase III study, 162 patients with relapsed or refractory MCL were randomly assigned (1:1:1) to receive one of two temsirolimus regimens: 175 mg weekly for 3 weeks followed by either 75 mg (175/75-mg) or 25 mg (175/25-mg) weekly, or investigator's choice therapy from prospectively approved options. The primary end point was progression-free survival (PFS) by independent assessment. RESULTS Median PFS was 4.8, 3.4, and 1.9 months for the temsirolimus 175/75-mg, 175/25-mg, and investigator's choice groups, respectively. Patients treated with temsirolimus 175/75-mg had significantly longer PFS than those treated with investigator's choice therapy (P = .0009; hazard ratio = 0.44); those treated with temsirolimus 175/25-mg showed a trend toward longer PFS (P = .0618; hazard ratio = 0.65). Objective response rate was significantly higher in the 175/75-mg group (22%) compared with the investigator's choice group (2%; P = .0019). Median overall survival for the temsirolimus 175/75-mg group and the investigator's choice group was 12.8 months and 9.7 months, respectively (P = .3519). The most frequent grade 3 or 4 adverse events in the temsirolimus groups were thrombocytopenia, anemia, neutropenia, and asthenia. CONCLUSION Temsirolimus 175 mg weekly for 3 weeks followed by 75 mg weekly significantly improved PFS and objective response rate compared with investigator's choice therapy in patients with relapsed or refractory MCL.
Environmental Pollutants And Human Diseases:Diagnosis And Treatment

Environmental factors play a central role in the processes of human development, health, and disease. Human exposure to hazardous agents in the air, water, soil, and food and to physical hazards in the environment is a major contributor to increased morbidity and mortality. Hazardous substances that originally are discharged as air pollutants may find their pathway to human exposure through multiple routes, including ingestion and dermal contact, as well as direct inhalation. The mechanisms for modeling and understanding the fate of air pollutants through atmospheric transport, deposition into water and soil, bioaccumulation, and ultimate uptake to receptor organs and systems in the human body are complex. A single contaminant source often may represent only a fraction of a total body pollutant burden. The EDTA chelation therapy enables the removal of toxic metals and excess calcium from the body. In this study we present results related to the detoxification treatment through continuous intravenous infusion of EDTA of 78 patients with cardiovascular problems and chronic fatigue syndrome. A comparison between toxic metals found in urine before and after the chelation-therapy treatment has been carried out. EDTA has been administered before urine collection, and a wide range of toxic metals (mercury, lead, arsenic, cadmium, nickel, and others) has been measured with reference to urine creatinine.
What are the demographic predictors in laparoscopic simulator performance?

Simulation is playing an increasingly important role in surgical education. There are a number of laparoscopic simulators of which the design and tasks vary considerably. It is unknown if any particular type may result in better outcomes for a specific population. This study assesses the predictors of acquisition of basic surgical skills on two different laparoscopic simulators.
Randomized, placebo-controlled, phase II study of sequential erlotinib and chemotherapy as first-line treatment for advanced non-small-cell lung cancer.

PURPOSE This study investigated whether sequential administration of erlotinib and chemotherapy improves clinical outcomes versus chemotherapy alone in unselected, chemotherapy-naïve patients with advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS Previously untreated patients (n = 154) with stage IIIB or IV NSCLC and Eastern Cooperative Oncology Group performance status of 0 or 1 were randomly assigned to receive erlotinib (150 mg/d) or placebo on days 15 to 28 of a 4-week cycle that included gemcitabine (1,250 mg/m(2) days 1 and 8) and either cisplatin (75 mg/m(2) day 1) or carboplatin (5 x area under the serum concentration-time curve, day 1). The primary end point was nonprogression rate (NPR) at 8 weeks. Secondary end points included tumor response rate, NPR at 16 weeks, duration of response, progression-free survival (PFS), overall survival (OS), and safety. RESULTS The NPR at 8 weeks was 80.3% in the gemcitabine plus cisplatin or carboplatin (GC)-erlotinib arm (n = 76) and 76.9% in the GC-placebo arm (n = 78). At 16 weeks, the NPR was 64.5% for GC-erlotinib versus 53.8% for GC-placebo. The response rate was 35.5% for GC-erlotinib versus 24.4% for GC-placebo. PFS was significantly longer with GC-erlotinib than with GC-placebo (adjusted hazard ratio, 0.47; log-rank P = .0002; median, 29.4 v 23.4 weeks); this benefit was consistent across all clinical subgroups. There was no significant difference in OS. The addition of erlotinib to chemotherapy was well tolerated, with no increase in hematologic toxicity, and no treatment-related interstitial lung disease. CONCLUSION Sequential administration of erlotinib following gemcitabine/platinum chemotherapy led to a significant improvement in PFS. This treatment approach warrants further investigation in a phase III study.