Miracle-dz/UniFAR-FTUs huggingface dataset:
The Prognostic Significance of Survivin Expression in Breast Cancer.

Purpose: Survivin is a member of the inhibitors of apoptosis family. It has recently comes into the limelight as a promising tumor marker, but many previous reports have shown controversial results regarding the significance and prognostic value of a survivin expression. In this study we determined the correlation between the survivin expression and the conventional prognostic markers and we also investigated the outcomes according to the localization of the survivin expression. Methods: Tissue microarray (TMA) blocks were made with formalin-fixed paraffin-embedded tissues from 185 breast cancer patients and the immunohistochemical staining was done using an anti-survivin antibody. Among these, 157 patients were available for a survivin expression. The conventional clinicopathologic features and overall survival were correlated with the localization of the survivin expression. Results: Survivin was expressed in 101 breast cancers (64.3%). A higher cytoplasmic survivin expression were noted in the older group (p=0.003), in the node-negative cancers (p= 0.012), in the earlier tumor stages (p=0.012) and in the cancers that had not been treated with adjuvant chemotherapy (p=0.014). On the contrary, a higher nuclear survivin expression was inversely correlated with an estrogen expression (p=0.006) and a progesterone receptor (p=0.043) expression. In terms of survival, a cytoplasmic expression was associated with improved overall survival (p=0.01) but a nuclear survivin expression was correlated with unfavorable overall survival (p=0.002). A high cytoplasmic to nuclear ratio of survivin was associated with improved overall survival (p=0.001) conversely, increased nuclear to cytoplasmic survivin ratio was correlated with unfavorable overall survival (p<0.0001). Multivariate analysis revealed that nuclear survivin expression (p= 0.001) and high nuclear to cytoplasmic survivin ratio (p=0.012) were independent predictor of overall survival. Conclusion: Survivin is frequently expressed in primary breast cancer. A cytoplasmic survivin expression is a good prognostic predictor for patients with axillary node negative early breast cancers and a nuclear survivin expression is a worse independent predictor of overall survival for patients with axillary node positive breast cancers.
When and how to discontinue antiplatelet therapy

Antiplatelet agents reduce the risk of ischaemic events but increase the risk of bleeding. When cardiac patients on antiplatelet therapy require surgery or invasive diagnostic procedures, a decision must be made whether or not to discontinue antiplatelet therapy. Because there is little evidence from clinical trials that would aid in the formulation of comprehensive recommendations, the decision must be made on an individual basis. The patient’s inherent risk for bleeding, concomitant treatments that may increase this risk, the potential of the procedure to cause bleeding, and the patient’s risk for ischaemic events if antiplatelet therapy is stopped all must be considered. Some procedures carry a low risk of bleeding and can be carried out in most patients without discontinuing antiplatelet therapy, whereas others require close evaluation and risk stratification of the patient. Patients on antiplatelet therapy undergoing cardiac surgery, those with drug-eluting stents, and those on anticoagulation require particularly careful management. There is an urgent need for research into this complex clinical problem.
Phase I Study of an AKT Inhibitor (MK-2206) Combined with Lapatinib in Adult Solid Tumors Followed by Dose Expansion in Advanced HER2+ Breast Cancer

Purpose: Preclinical data support combining AKT inhibitors with HER2-targeted therapies to overcome resistance to treatment. This phase I study combined the investigational AKT inhibitor, MK-2206, with lapatinib to determine the MTD. Experimental Design: The dose escalation cohort enrolled adults with advanced solid tumors, who received MK-2206 dosed 30 to 60 mg every other day and lapatinib 1,000 to 1,500 mg daily continuously, escalated using a 3+3 design. Cycles were 28 days except cycle 1 (35 days, including an initial 8 days of MK-2206 alone to evaluate pharmacokinetic interactions). The dose expansion cohort enrolled adults with advanced HER2+ breast cancer. Results: Twenty-three participants enrolled in the dose escalation cohort. Dose-limiting toxicities were hyponatremia, fatigue, rash, hypocalcemia, and mucositis. Common toxicities included diarrhea, nausea, and rash. The MTD was reached at MK-2206 45 mg orally every other day and lapatinib 1,500 mg orally daily. Two participants maintained stable disease for >4 months, including a colorectal cancer participant with substantial carcinoembryonic antigen decrease. Of 5 participants in the dose expansion cohort, 2 maintained stable disease for >6 months, including one with prior progression on single-agent lapatinib. Plasma MK-2206 concentrations decreased after addition of lapatinib, but in vitro studies indicate lapatinib increases the intracellular levels of MK-2206. Conclusions: MK-2206 combined with lapatinib can be tolerated with both drugs above biologically active single-agent doses. Overlapping toxicities result in significant diarrhea and rash, which can be managed medically. Antitumor activity was promising and supports evaluation of AKT inhibitors combined with HER2-targeted therapies. Clin Cancer Res; 22(11); 2659–67. ©2016 AACR.
Computer Simulation of Antidromic Facial Nerve Response Waveform

Conclusion: An assessment of facial nerve (FN) damage on the basis of antidromic facial nerve response (AFNR) was established by computer simulation analysis. Computer simulation has the advantage of being able to assume any type of lesion. In the near future, computer analysis should provide another experimental method which displaces animal experiments, thus circumventing the ethical dilemma associated with animal experiments. Background: AFNR is a promising method to monitor intratemporal FN lesions. Clinical application of AFNR showed that waveform changes reflected the site and degree of the lesion. However, the association between the waveform changes and pathologic conditions of FN remains to be clarified. Objective: To analyze the association between waveform changes and the degree and site of nerve degeneration or blockade with the use of computer simulation, and to speculate the degree and involvement of the intratemporal FN lesions underlying the changes of AFNR waveforms. Methods: AFNR waveform, latency and amplitude changes in various types of nerve conduction block in the intratemporal FN were analyzed with the use of a computer simulation program based on the solid-angle approximation theory. Result: The present computer simulation revealed a temporal increase in the peak-to-peak amplitude between 1st and 2ndwaves, when the nerve blockade extends 1 mm distally from the recording site. Generally, AFNR in severe palsy cases gradually decreases in amplitude as the waveform change from biphasic to monophasic, ultimately falling into non-response. According to the computer simulation, the decay of AFNR reflects conduction blocking in 63% or more of FN fibers. The amplitude ratio of the first positive/negative wave was indicative of the site of the lesion in relation to the recording site. The ratios were <0.586 when the lesions were situated >1 mm proximal and they were >0.667 when the lesions were peripheral to the recording site.
The Influence of Visual Information on the Motor Control of Table Tennis Strokes

Theories of social interaction (i.e., common coding theory) suggest that visual information about the interaction partner is critical for successful interpersonal action coordination. Seeing the interaction partner allows an observer to understand and predict the interaction partner's behavior. However, it is unknown which of the many sources of visual information about an interaction partner (e.g., body, end effectors, and/or interaction objects) are used for action understanding and thus for the control of movements in response to observed actions. We used a novel immersive virtual environment to investigate this further. Specifically, we asked participants to perform table tennis strokes in response to table tennis balls stroked by a virtual table tennis player. We tested the effect of the visibility of the ball, the paddle, and the body of the virtual player on task performance and movement kinematics. Task performance was measured as the minimum distance between the center of the paddle and the center of the ball (radial error). Movement kinematics was measured as variability in the paddle speed of repeatedly executed table tennis strokes (stroke speed variability). We found that radial error was reduced when the ball was visible compared to invisible. However, seeing the body and/or the racket of the virtual players only reduced radial error when the ball was invisible. There was no influence of seeing the ball on stroke speed variability. However, we found that stroke speed variability was reduced when either the body or the paddle of the virtual player was visible. Importantly, the differences in stroke speed variability were largest in the moment when the virtual player hit the ball. This suggests that seeing the virtual player's body or paddle was important for preparing the stroke response. These results demonstrate for the first time that the online control of arm movements is coupled with visual body information about an opponent.
Audit of the efficiency of a community pharmacy dispensing service

in audit was undertaken in a Belfast community pharmacy to establish if wescriptions were being dispensed to patients within a reasonable time. The btandard set was that 95 per cent of all prescriptions should be dispensed to the Batient or hisher representative within 10 minutes of receipt. Over a three-month 3eriod, data were collected on the time patients waited in the pharmacy and on wescription items that were not, or were only partially, dispensed. On analysis of :he data, it was found that the standard was being achieved. Recommendations for mproving the standard were made and implemented. In a second audit cycle an mmovement was noted.
Factors Affecting Successful Isolation of Human Corneal Endothelial Cells for Clinical Use

Corneal transplantation is a common transplant procedure used to improve visual acuity by replacing the opaque or distorted host tissue with clear healthy donor tissue. However, its clinical utility is limited due to a lack of donor supply of high-quality corneas. Bioengineered neocorneas, created using an expandable population of human donor-derived corneal endothelial cells (HCECs), could address this shortage. Thus, the objective of this study was to evaluate HCEC sourcing with various isolation methods, including enzymatic digestion, culture medium components, and adhesive proteins. HCECs were obtained from corneas obtained from various aged donors after endothelial keratoplasty. Under a dissection microscope, the Descemet's membrane, including the attached corneal endothelium, was stripped from the stroma, and the cells were isolated and expanded by explant culture or by enzymatic digestion with enzymes such as collagenase II, dispase, or trypsin. In order to improve the initial cell attachment, tissue culture plates were coated with collagen IV, fibronectin, or fibronectin–collagen combination coating mix (FNC) before cell plating. We were able to successfully obtain HCECs from 32% (86/269) of donor corneas. Donor age and isolation method influenced the characteristics of the resulting in vitro HCEC culture. Under all conditions tested, FNC-coated plates showed higher quality cultures than the other coatings tested. These results suggest that donor age and HCEC isolation methodology are the two factors that most directly affect the quality of the resulting HCEC culture in vitro. These factors should guide the methodological development for the clinical expansion of HCECs for the generation of bioengineered neocorneas.
Association of the brain-derived neurotrophic factor Val66Met polymorphism with hippocampus volumes in drug-free depressed patients

Abstract Objectives. Val66Met BDNF gene polymorphism is shown to affect the function of mature BDNF and mature BDNF plays an important role in the hippocampal neurogenesis and neuronal survival. Methods. A relationship of Val66Met BDNF gene polymorphism and hippocampal volumes in 33 MDD patients and 40 healthy controls is investigated. Region of interest analysis was conducted on the images acquired via MRI. Results. Depressed patients had smaller left hippocampal volumes compared to healthy controls. The diagnosis of MDD was not significantly related to hippocampal volumes among Met carriers; however, among Val homozygotes depressed patients had significantly smaller left hippocampal volumes compared to controls. Although both right and left hippocampal volumes showed nearly significant correlation with the duration of illness, this correlation reached (negative) significant levels only in the right hippocampal volume of the Val homozygotes. Conclusions. Val homozygote genotype may serve as a vulnerability factor in MDD regarding hippocampal volume loss. This finding can be considered as a supportive evidence for the neurotrophic factor hypothesis of depression.
Baroreflex contribution to linear and nonlinear blood pressure and heart rate coupling in daily life: an assessment by cross-mutual information

A new procedure has been developed to (1) investigate the coupling between arterial blood pressure and heart rate variability in daily life and (2) identify the baroreflex contribution to such a coupling. The algorithm is based on the estimation of cross-mutual information (CMI) between systolic blood pressure (SBP) and RR-interval (RRI) beat-to-beat values. CMI has been selected because of its capability to quantify both linear and nonlinear components of the coupling between variables. This procedure has been used to analyze data recorded in spontaneously behaving cats before and seven days after surgical opening of the baroreflex loop as obtained by a sino-aortic denervation. Use of CMI indicates that over a time scale on the order of minutes the arterial baroreflex is the major determinant of the SBI-RRI link, accounting for about 2/3 of the total (linear and nonlinear) coupling measured between these variables.
Scavenger Receptor Class B Type I Is a Plasma Membrane Cholesterol Sensor

Rationale: Signal initiation by the high-density lipoprotein (HDL) receptor scavenger receptor class B, type I (SR-BI), which is important to actions of HDL on endothelium and other processes, requires cholesterol efflux and the C-terminal transmembrane domain. The C-terminal transmembrane domain uniquely interacts with plasma membrane (PM) cholesterol. Objective: The molecular basis and functional significance of SR-BI interaction with PM cholesterol are unknown. We tested the hypotheses that the interaction is required for SR-BI signaling, and that it enables SR-BI to serve as a PM cholesterol sensor. Methods and Results: In studies performed in COS-M6 cells, mutation of a highly conserved C-terminal transmembrane domain glutamine to alanine (SR-BI-Q445A) decreased PM cholesterol interaction with the receptor by 71% without altering HDL binding or cholesterol uptake or efflux, and it yielded a receptor incapable of HDL-induced signaling. Signaling prompted by cholesterol efflux to methyl-&bgr;-cyclodextrin also was prevented, indicating that PM cholesterol interaction with the receptor enables it to serve as a PM cholesterol sensor. Using SR-BI-Q445A, we further demonstrated that PM cholesterol sensing by SR-BI does not influence SR-BI-mediated reverse cholesterol transport to the liver in mice. However, the PM cholesterol sensing does underlie apolipoprotein B intracellular trafficking in response to postprandial micelles or methyl-&bgr;-cyclodextrin in cultured enterocytes, and it is required for HDL activation of endothelial NO synthase and migration in cultured endothelial cells and HDL-induced angiogenesis in vivo. Conclusions: Through interaction with PM cholesterol, SR-BI serves as a PM cholesterol sensor, and the resulting intracellular signaling governs processes in both enterocytes and endothelial cells.
Reversal of Abnormalities in Ocular Fluorophotometry in Insulin-dependent Diabetes After Five to Nine Months of Improved Metabolic Control

Abnormalities in ocular fluorophotometry occur in human and experimental diabetes mellitus. To determine the reversibility of these abnormalities, we studied prospectively 11 intensively treated and 25 conventionally treated insulin-dependent diabetics (IDD) preselected because of abnormal vitreous fluorophotometry. Among the 25 IDD treated conventionally with one or two insulin injections daily, hemoglobin A1C concentrations remained elevated and fluorescein concentration, 1 h after the intravenous injection of fluorescein (7 mg/kg), did not change significantly in either the anterior chamber or the posterior vitreous. Among 11 IDD treated intensively with home blood glucose monitoring and pumped subcutaneous insulin or three or more injections daily, hemoglobin A1C fell dramatically (10.4 ± 0.7% to 7.5 ± 0.2%) and anterior chamber fluorescein concentration decreased (73.9 ± 7.7 to 49.5 ± 5.3 ng/ml). Two patients with proliferative retinopathy showed no improvement in their massive vitreous fluorescein accumulation and subsequently required photocoagulation. In the nine subjects without proliferative retinopathy, vitreous fluorescein accumulation decreased in eight (10.6 ± 0.7 to 6.5 ± 0.5 ng/ml) and was normal in six after 1 yr. The only subject with increasing vitreous fluorescein accumulation also had concurrent worsening of background retinopathy. These studies support the hypothesis that moderate abnormalities in ocular fluorophotometry are due to reversible changes in ocular tissues, such as retinal pigment epithelium. Fluorescein leakage emanating from the advanced vascular or retinal abnormalities of proliferative retinopathy were not reversed with the degree and duration of metabolic control achieved in the present study. The long-term significance of the reversal of moderate abnormalities in fluorophotometry is not clear at the present time.
The SAFE AT HOME: A Quick Home Safety Assessment

Home safety is an important consideration for most occupational therapy practitioners. The SAFE AT HOME screening tool for home safety awareness is being developed in three phases. The first two phases, reported here, involve setting up potentially unsafe situations in a kitchen setting, having participants identify these problems and explain how they could be fixed. A sample of older participants (N = 126) completed these two phases of the SAFE AT HOME for norming purposes. Results of testing demonstrate that the scores on the SAFE AT HOME differentiate between independent living and long-term care populations. Spearman Brown reliability was determined to be . 85. The twelve test items were analyzed for their applicability and ability to differentiate among test takers. Eleven of the twelve items were found to be adequate discriminators.
Evaporation assisted CdSe nanorod assembly by small angle X-ray scattering and langmuir adsorption.

Using evaporative assembly of dilute (<3 wt %) CdSe nanorod solutions, we combine Langmuir adsorption and small-angle X-ray scattering (SAXS) to estimate the onset of nanorod alignment instigated by the dipolar character of CdSe nanorods. SAXS demonstrates that the peak scattering intensity increases along the diameter toward the center of each dry assembly. By agreement of SAXS and profilometry results, we have established a practical access window into the lyotropic feature of emergent orientational order or alignment in nanorod solutions. With a mean field approach involving the rod-rod or dipole-dipole interaction, i.e., Keesom interaction, and the observation that the nanorod dipole moment scales with nanorod volume, we demonstrate that reaction constants result in nanometer scale interparticle separations which increase with aspect ratio or excluded volume. We compute a SAXS weighted intensity alignment parameter, which improves with aspect ratio, to indicate edge-to-center orientational ordering within dry nanorod assemblies.
ESTUDIO SEROEPIDEMIOLÓGICO PARA ESTIMAR EL RIESGO DE INFECCIÓN CONGÉNITA POR Toxoplasma gondii EN GUAYAQUIL, ECUADOR

Serological testing, by indirect haemagglutination and ELISA was performed in 4 age groups: 0 to <5, 5 to <10, 10 to <15 and 15 to <20 years old, to find prevalence and quinquennial incidence. An interview to assess risk factors was performed. The statistical analysis was performed for independent variables and bivariate correlations to calculate the odds ratio. The total number of observations was 578: 285 male and 292 female (1 not determined) and median age was 9.7. An increase in the prevalence was related to age, reaching 60.2% in the group between 15 and 20 years old, when compared to the same age group in 1989 (78.3%) showing an 18% decrease. Several hypotheses to explain this decrease were proposed. There is a steep increase at the age of 10. The statistical analysis does not demonstrate a direct correlation with any of the risk factors consigned in the interview, with the exception of exposure to young felines (kittens). The risk for acquiring congenital toxoplasmosis was estimated as 1.8 per thousand (18 per ten thousand), hence 106 cases are expected per year, with 69 (65%) of them being asymptomatic, and 37 with different degrees of severity: 17 with mild, 11 severe and 9 with death at birth. Each year there would be 28 newborns with evident lesions and additionally an undetermined number of cases with late onset lesions within the initially asymptomatic group (65%), with unknown socioeconomic impact.
Integration of umbilical venous and arterial Doppler flow parameters for prediction of adverse perinatal outcome

Background: Quantification of umbilical vein (UV) blood flow rate and umbilical artery Doppler indices might be valuable in assessing fetuses at increased risk of perinatal complications as they receive their supply of oxygen and nutrients through this vessel. Previous studies have indicated that UV blood volume flow rate to umbilical artery pulsatility index (UAPI) ratio (venous arterial index [VAI]) evaluates both venous and arterial arm of fetal umbilical circulation and hence, can be adopted as a screening tool in management of high risk pregnancy. Objectives: To compare umbilical VAI with adverse perinatal outcome and also to evaluate its efficacy with other flow indices in determining perinatal outcome. Materials and Methods: Various Doppler indices such as normalized blood flow rate in UV (nUV, ml/kg estimated fetal weight/min), VAI (nUV/UAPI), umbilical artery resistance index (RI), UAPI, and systolic diastolic ratio were determined in 103 pregnant women within 2 weeks of the delivery. A risk score was devised using APGAR at 5 min, birth weight, preterm delivery, fetal distress, Neonatal Intensive Care Unit (NICU) care, and perinatal death and this score was correlated with antenatal Doppler findings. Results: Subjects with low VAI were found to have a greater association with intrauterine growth restricted fetuses (28.5%) and low liquor (35.7%), preterm deliveries (46.4%), lower mean birth weight (2.25 kg), higher NICU admission rates (32.1%). The unfavorable score was noticed in 25.2% of the neonates. They had lower VAI (156 vs. 241), UV diameter (6.2 mm vs. 7.8 mm), UV velocity (16.2 vs. 17.8), nUV (163.7 vs. 206.4), and higher PI (1.3 vs. 0.9). A cut-off of VAI of 105 ml/kg/min had sensitivity of 86.7% and a specificity of 93.5% for predicting poor perinatal outcome. Conclusion: VAI with a cut-off of 105 ml/kg/min can be used as an additional tool along with the other conventional Doppler indices in order to predict adverse fetal outcome.