Miracle-dz/UniFAR-FTUs huggingface dataset:
The effects of immunosuppressive agents on inflammatory response in septic rats

Sepsis remains a serious clinical problems resulting in high morbidity and mortality. We aimed to investigate the inflammatory response in a septic rat model treated with immunomodulator agents. We used the cecal ligature and puncture model to establish septic peritonitis in rats. Male Wistar-Albino rats were randomized into groups of seven rats each and assigned different regimens: Tacrolimus 1 mg/kg/day, cyclosporin-A 5 mg/kg/day and methylprednisolone 15 mg/kg/day. These immunsuppressive agents were applied at the 6 and 48 hour intraperitoneally. The animals were euthanized after 6 and 48 hours and systemic parameters including, IL-2, IL-6, TNF-a, CRP, AST and creatinine were examined. Our study demonstrated that the experimental peritonitis model caused a meaningful rise in the values of systemic parameters. This was especially apparent for early-applied cyclosporin A; in addition, tacrolimus significantly decreased the levels both at the 6 and 48 hour. The excess immune response in complex sepsis treatment might be restrained using immunosuppressive agents administered early. Although additional supportive, comprehensive, experimental and clinical studies are still needed, this therapy model may prove to be an alternative for the future.
"Job Stress: A Continuing Education Program for Today's Nurse" Program References

Work engagement and occupational stress in nurses and other healthcare workers: The role of organizational and personal factors. traumatic stress in trauma nurses. An investigation of the relationship between safety climate and medication errors as well as other nurse and patient outcomes. (2013). Stress in nurses: Stress-related affect and its determinants examined over the nursing day. extending the triple match principle in the nursing profession: A generational perspective on the job demands, job resources and strain at work.
THESIS SUBMITTED FOR THE DEGREE OF DOCTOR OF PHILOSOPHY

iv PART ONE: CONCEPTUALISING THE URBAN LAND DEBATE Chapter 1: Introduction 1 1.1 Key questions and arguments 5 1.2 Conceptual Framework 7 1.3 Dissertation format 8 1.4 Limitations 11 PART TWO: DELIBERATING THE URBAN LAND QUESTION Chapter 2: Sen’s freedoms and the good city 13 2.
Update on Management of Heart Failure - Part II

The Hong Kong Medical Association is dedicated to providing a coordinated CME programme for all members of the medical profession. Under the HKMA CME Programme, a CME register is installed to document the CME efforts of doctors and special CME avenues are provided. The Association strives to foster a vibrant environment of CME throughout the medical profession. Both members as well as non-members of the Association are welcome to join us. You may contact the HKMA Secretariat for details of the programme. 香港醫學會致力推動持續醫學進修,醫學會體察到業界有必要設立完善的持續進修計劃,為同僚建立有系統的進修記錄機制,以及為全科醫生提供適切的進修課程。 藉著這個計劃,我們期望將優良的進修 傳統推展至醫學界中每一角落,同時為業界締造一個充滿活力的進修文化。 我們誠意邀請你參與醫學會持續進修計劃,不論你是否醫學會的會員,均歡迎你同來與我們一同學習,以及享用醫學會為所有醫 生設立的進修記錄機制。 如欲了解香港醫學會持續醫學進修計劃的詳情,請聯絡本會秘書處查詢。 每月自修資料 請細閱以下文章,並利用第十七頁之答題紙完成自我評估測驗。 香 港醫學會持續醫學進修計劃參加者如於二零零六年七月十五日前, 將已填妥之答題紙傳真或寄回本會秘書處,將可獲持續醫學進修一 個積分點;至於是期自我評估測驗之答案,將刊於下一期《持續醫學 進修專訊》之中。 (本會秘書處傳真號碼:2865 0943) MONTHLY SELF-STUDY SERIES Please read the following article and complete the self-assessment questions. Participants in the HKMA CME Programme will be awarded 1 credit point under the Programme for returning completed answer sheet on p.17 via fax (2865 0943) or by mail to the HKMA Secretariat on or before 15 July 2006. Answers to questions will be provided in the next issue of the HKMA CME Bulletin. Update on Management of Heart Failure – Part II Dr. WONG Tai Hung, John M.B. ,B.S. Hons. (Monash), M.R. C.P. (UK), F.H. K.C.P. Resident Specialist, Division of Cardiology Department of Medicine and Geriatrics, United Christian Hospital Dr. CHAN Wai Kwong, Andy M.B. ,B.S. (HK), F.R. C.P. (Lond), F.R. C.P. (Edin), F.R. C.P. (Glasg), F.R. C.P. (Irel), F.H. K.C.P., F.H. K.A.M. (Med) Consultant Cardiologist & Head, Division of Cardiology Department of Medicine and Geriatrics, United Christian Hospital
Books Received

choose to borrow from these traditions, then we must fit the concepts and technological innovations into our field theoretically and subject them to a recursive process of analysis and revision based on empirical scientific methods, without being limited by their religious or spiritual past. Mindfulness-based cognitive therapy for prevention of relapse in major depression (3) and dialectical behaviour therapy for borderline personality disorder (4) are 2 examples of successful integrations of Buddhist concepts and practices into contemporary psychotherapy. In our own work, we have taken the position that such concepts and technologies—particularly those based on Buddhist mindfulness practices—can be theoretically integrated with current models of psychopathology, possibly leading to innovations in treatment (5).
Contributions and Limits of a Clinical Approach to Work in the Development of Nursing Students’ Professional Identity

This article focuses on nursing students’ health issues when learning their trade. These issues are considered from their ability to endorse the responsibility of their acts to their assumption of performance of their practices in light of their professional identity. The aim was to study the contribution of the nursing students’ activity analysis to the development of their professional identity throughout this reflective activity. The cross confrontation plan, in which video was used for observations, has enabled to show the evolution of the conflict of ideas between meaning and efficiency by the variation of people involved, first of all the researcher, then another student and at last professional participants. Four voluntary students in their third year class, who most likely have developed more professional norms than the first year class students, have analyzed, as a pair of peers, a comparable care they made during a surgery work experience to some patients who were voluntary too. Willing to understand the global care, the students have chosen to be filmed while interacting with the patients. They wanted to go beyond the technical act. Therefore the indirect historical method of the clinical approach of activity has induced the development of the student’s reflection both on their way nursing and on their way of being regarding the profession they are learning. The dialogic observatory generated both by the four nursing students discussing their care and by four expert trainers analyzing these reflections, has highlighted how the discursive activity between students has contributed to transform their care and their professional identity all together. Moreover, as a pair, the trainers have debated about the nursing activities and the professional identity. They have discussed capitalizing students’ agreements for further use in teaching and questioned their own practices. Their exchanges, built upon watching significant video extracts of students’ confrontations, led them to a better understanding of how the students may go beyond the set tasks, not only by making theirs the professional rules, but also by creating their own professional rules. The nursing students have thus become resources for the learning organization. The proposed analysis model can therefore be useful to nursing trainers as well as tutors.
Eye Movement Dysfunction as a Biological Marker of Risk for Schizophrenia

Objective: Our aim was to review smooth pursuit eye movement (SPEM) studies in schizophrenia and groups at high risk for schizophrenia, with a view to evaluating the utility of SPEM dysfunction as a biological marker of risk for schizophrenia. Method: Smooth pursuit eye movement studies, related saccade function and the unresolved issues in this area of schizophrenia research were addressed. The different perspectives on the trait marker status of SPEM dysfunction, provided by both high-risk studies and related developmental research were considered. Attention was also given to the relationship between eye movement dysfunction and symptom profiles. Results: Converging evidence points to the robust and specific nature of SPEM dysfunction in schizophrenia, and highlights the role of frontal lobe and a related network dysfunction. The vast majority of 'high risk' studies support the view that SPEM dysfunction is also genetically specific to schizophrenia, and is not simply due to the overt expression of this illness. Studies assessing SPEM in relation to symptomatology show an association with the Disorganisation syndrome in particular. Conclusions: Evidence for the specificity of SPEM dysfunction to diagnosed schizophrenia, as well as to healthy individuals with a genetic vulnerability to schizophrenia, suggests that the SPEM task has efficacy as a test of gene carrier status in schizophrenia, and therefore as a trait marker of risk for schizophrenia. Future studies should seek to explore the relationships between SPEM and other eye movement dysfunctions (antisaccades, express saccades), in view of evidence that some of these dysfunctions also show specificity for schizophrenia.
Researchd fibroblasts are positively correlated with metastatic potential of human gastric cancers

Background: The prognosis of gastric cancer patients is difficult to predict because of defects in establishing the surgical-pathological features. Cancer-associated fibroblasts (CAFs) have been found to play prominent role in promoting tumor growth, invasion and metastasis. Thus raises the hypothesis that the extent of CAFs prevalence may help to establish the prognosis of gastric cancer patients. Methods: Immunochemistry and realtime-PCR experiments were carried out to compare the expression of proteins which are specific markers of CAFs or secreted by CAFs in the tumor and normal tissue specimens. The extent of CAFs' prevalence was graded according to immunochemical staining, and correlation was further analyzed between CAFs' prevalence and other tumor characteristics which may influence the prognosis of gastric cancer patients. Results: Nearly 80 percent of normal gastric tissues were negative or weak positive for CAFs staining, while more than 60 percent of gastric cancer tissues were moderate or strong positive for CAFs staining. Realtime-PCR results also showed significant elevated expression of FAP, SDF-1 and TGF-β1 in gastric cancer tissues compared to normal gastric tissues. Further analysis showed that CAFs' prevalence was correlated with tumor size, depth of the tumor, lymph node metastasis, liver metastasis or peritoneum metastasis. Conclusions: Reactive cancer associated fibroblasts (CAFs) were frequently accumulated in gastric cancer tissues, and the prevalence of CAFs was correlated with tumor size, depth of the tumor and tumor metastasis, thus give some supports for establishing the prognosis of the gastric cancer patients.
Baseline Lymphopenia: A Predictor Of Poor Outcomes In HER2 positive Metastatic Breast Cancer Treated With Trastuzumab

Purpose Despite selection based on human epidermal growth factor receptor 2 (HER2) overexpression, not all HER2-positive patients benefit from trastuzumab therapy. Recent reports indicate that trastuzumab treatment failure may be associated with immune system dysfunction. We examined the prognostic relevance of the absolute lymphocyte count (ALC) in patients with HER2-positive metastatic breast cancer (MBC) who received trastuzumab combined with chemotherapy. Methods Baseline ALC and neutrophil-to-lymphocyte ratio (NLR) data from trastuzumab-treated patients with MBC were studied retrospectively, and associations between baseline ALC and clinical characteristics evaluated. Kaplan–Meier analysis and the Cox regression hazard model were applied to assess effects on outcomes. Results Of a total of 68 patients, 19.1% (13/68) had baseline ALCs ≤ 1 G/L. Baseline lymphopenia was correlated with increased lactate dehydrogenase (LDH) and higher NLR. In univariate analysis, higher alkaline phosphatase (ALP) was associated with inferior overall survival (OS) (P = 0.001); higher LDH was associated with inferior progression-free survival (PFS) (P = 0.045) and OS (P = 0.010). We did not observe any differences in objective response rate or disease control rate between patients with lymphopenia and those with normal ALC. Importantly, patients with baseline lymphopenia had inferior PFS (0.60 years vs 1.17 years, P = 0.000009) and OS (1.88 years vs 3.80 years, P = 0.0003). In multivariable analysis, significance of ALCs was retained for lymphopenia (PFS: P = 0.0005; OS: P = 0.016). Conclusion Our data indicate that baseline ALC value of ≤1 G/L is a predictor of poor outcomes, but not of response, in patients with MBC treated with trastuzumab.
First trimester screening and Down syndrome

The purpose of this study was to evaluate extended first trimester screening for severe chromosomal disorders and adverse pregnancy outcomes in singleton pregnancies among the general population in Finland. Maternal serum biochemical markers, pregnancy associated plasma protein-A (PAPP-A) and free beta human chorionic gonadotropin (fβ-hCG), and fetal nuchal translucency (NT) thickness were measured during the gestational weeks 8+0–13+6. A computerized risk figure program was used to calculate an individual risk figure for chromosomal disorders. It was investigated whether the screening parameter, PAPP-A, is associated with adverse pregnancy outcomes. The prevalence of Down syndrome (DS) cases in Finland during the years 2002–2006 was 1:364 (N=795). The proportion of women aged 35 years or older increased from 5–10% in the years 1980–1990 to 19.1% during the study period. Most DS cases (61.1%) presented in that age group. The first trimester combined screening for Down syndrome yielded a detection rate (DR) of 81.9% for a 4.3% false positive rate (FPR). The performance was evaluated among 76949 voluntary women during the study period of 01.05. 2002–31.12. 2008. There were 188 cases of DS. The screening worked better among the older women. The number of invasive procedures needed to detect one case of DS was higher among the younger women. Adding specific algorithms for screening of other chromosomal abnormalities yielded DR of 74.0% for trisomy 18 (T18) and 54.5% for trisomy 13 (T13) with an additional increase of 0.3% FPR. For chromosomal abnormalities other than T18 and T13, the specific algorithms did not improve the screening performance. Low first trimester maternal serum levels of PAPP-A (≤0.30 MoM) were significantly associated with small for gestational age (SGA) newborns and stillbirths (SBs). The combined screening method for DS works well in practice and has been standardized in Finland. In screening for trisomies 18 and 13 a specific algorithm is reasonable. Low first trimester levels of PAPP-A could be used as an independent marker for pregnancies at high risk for SGA babies and SBs.
Association Between Gastric Lymphoid Follicles (Precursor Of MALT Lymphomas) And H. pylori Infection At A Referral Hospital In Iran

Purpose: Mucosa-associated lymphoid tissue (MALT) is the most common endoscopic ﬁ nding in Helicobacter pylori positive patients that can progress to MALT lymphoma after a prolonged antigenic contact. This study was aimed to evaluate the prevalence of lymphoid follicles and aggregates (precursors of MALT lymphomas) in gastric mucosal biopsies and their correlation with H. pylori infection. Patients and methods: In this study, 100 patients who had undergone an upper gastrointestinal endoscopy were enrolled. Five biopsy specimens were taken each patient through screening endoscopy and histopathological changes were evaluated and graded using the Wotherspoon System. The clinical background and H. pylori infection status were also investigated. Results: Among the 100 cases in our series, 79 patients (79%) showed evidence of MALT in at least one biopsy specimen taken from the stomach and 21 cases (21%) had no evidence of MALT. H. pylori infection was detected in 74 (74%) patients. Lymphoid follicles were detected more frequently in H. pylori -positive patients (59%) compared to H. pylori -negative cases (3%) (P<0.001). Conclusion: The frequency of lymphoid follicles and aggregates in gastric mucosal is associated with H. pylori infection. Further community-based studies in larger sample sizes using a combination of microscopic methods and PCR assay are required for effective monitoring of H. pylori infection.
Asian American grandparents caring for grandchildren: Findings from the Census 2010-2012 American Community Survey

Research on grandparent caregivers has received growing attention, yet information about Asian American grandparents is limited. Using 2010-2012 American Community Survey (ACS) data, this study provides a national profile of Asian American grandparent caregivers across ethnic groups by region (East, Southeast, and South Asians) and examines socioeconomic and cultural factors related to grandparent caregiving. Of the over half a million Asian Americans who lived with grandchildren during 2010-2012, about 16% reported as primary caregivers, and over 31% lived in grandparent-headed households. Compared with East Asians, South Asian grandparents were less likely to be primary caregivers for their grandchildren, but no difference was observed between East and Southeast Asians. East Asian grandparents, especially noncitizens, were more likely to care for their grandchildren than native born citizens. Marital status, citizenship, language spoken at home, employment, and poverty level were related to the odds of being the primary caregivers, but the relationships varied by ethnic groups. Findings indicate ethnic heterogeneity in Asian American grandparent caregiving and the necessity for future research in this understudied population. In general, grandparent caregivers and their households may face greater financial challenges than non-caregivers. Attention and effort are needed in policy and practice arenas to address specific individual and household needs after taking into account ethnic, cultural, and economic characteristics.
Micro/nano-bubble-assisted ultrasound to enhance the EPR effect and potential theranostic applications

Drug delivery for tumor theranostics involves the extensive use of the enhanced permeability and retention (EPR) effect. Previously, various types of nanomedicines have been demonstrated to accumulate in solid tumors via the EPR effect. However, EPR is a highly variable phenomenon because of tumor heterogeneity, resulting in low drug delivery efficacy in clinical trials. Because ultrasonication using micro/nanobubbles as contrast agents can disrupt blood vessels and enhance the specific delivery of drugs, it is an effective approach to improve the EPR effect for the passive targeting of tumors. In this review, the basic thermal effect, acoustic streaming, and cavitation mechanisms of ultrasound, which are characteristics that can be utilized to enhance the EPR effect, are briefly introduced. Second, micro/nanobubble-enhanced ultrasound imaging is discussed to understand the validity and variability of the EPR effect. Third, because the tumor microenvironment is complicated owing to elevated interstitial fluid pressure and the deregulated extracellular matrix components, which may be unfavorable for the EPR effect, few new trends in smart bubble drug delivery systems, which may improve the accuracy of EPR-mediated passive drug targeting, are summarized. Finally, the challenging and major concerns that should be considered in the next generation of micro/nanobubble-contrast-enhanced ultrasound theranostics for EPR-mediated passive drug targeting are also discussed.
Avaliação do percentual de gordura corporal em relação à esteatose hepática no pós-operatório de bypass gastrointestinal

INTRODUCTION: The prevalence of fatty liver increased concomitantly with the growth of the global obesity epidemic has become. Steatosis affects most patients with morbid obesity and may progress to more severe forms of liver disease nonalcoholic fatty, such as nonalcoholic steatohepatitis and cirrhosis. The aim of this study is to evaluate the body fat of bariatric patients followed at the Center for Obesity and Metabolic Syndrome of PUCRS and analyze its relationship with hepatic hepatic steatosis. METHODS: This is a historical cohort study that compares the disease of nonalcoholic fatty liver for liver biopsies and the percentage of fat by bioimpedance preoperatively segmented and in these same patients 1 year after surgery. The degree of hepatic steatosis and body fat percentage, was analyzed by relating them to the body mass index, waist-hip ratio, weigth loss, blood glucose and other comparative data regarding age and gender. RESULTS: Of 25 patients undergoing gastrointestinal bypass surgery will be included in the study met all inclusion criteria and 5 were male and 20 female with mean age of 37,6±12,6 years. In this study, the difference in the percentage of fat in preoperatively and postoperative period in an average of 25,9±10,2. Of the 12 (48%) individuals who regressed 2 degrees of the disease, had a percentage difference of 14,3±4,2 in the amount of body fat, 5 (20%) patients regressed 3 degrees with a mean of 11,4±9,0 and 3 (12%) subjects regressed 4 degrees with an average of 11,0±2,4 percentage of difference of body fat in relation to preoperative and one year after surgery. CONCLUSION: Of 25 patients analyzed %, showed improvement in hepatic steatosis. However, the patients who showed a smaller loss in percentage fat, were the patients who regressed more in steatosis or nonalcoholic steatohepatitis after one year of bariatric surgery.
Parking Prices, Parking Availability and Work Commute Mode Choices: Evidence from Los Angeles County

Parking availability and parking prices affect the probability of choosing car as a commute mode. We have examined California Household Travel Survey data that was merged with geographical and contextual data as well as with a unique set on parking data for Los Angeles County and shown that this is the case for workplace parking in LA County. Our analyses show that parking prices have a significant negative impact on the decision to drive alone to work, and marginal effects computations indicate that a 10% increase in parking prices may decrease the probability of driving alone to work by 0.6%. Our multinomial logit results indicate further that higher parking prices shift people away from driving alone to using public transit. Another interesting find is that off-street parking availability at the workplace location correlates positively with the probability of driving (either carpooling or alone) to work and also increases the probability of solo driving over active commuting (biking or walking). The policy-relevant implication of these results is that maximum parking standards and removal of car parking and eligible car parking expense payment fringe benefits may reduce caruse on trips to work.