Miracle-dz/UniFAR-FTUs huggingface dataset:
Diabetes affects everything: Type 2 diabetes self‐management among Spanish‐speaking hispanic immigrants

This article is a report of qualitative findings of a mixed-methods study of the relationships among knowledge, self-efficacy, health promoting behaviors, and type 2 diabetes mellitus (T2DM) self-management among limited-english-proficient recent Hispanic immigrants, a population with increased incidence of T2DM and barriers to successful T2DM management. Semi-structured interviews were conducted with 30 participants, and physiological and demographic data also were collected. The participants generally attributed developing the disease to strong emotions and viewed T2DM as a serious disease. Although a majority understood the importance of exercise and diet in T2DM self-management, other aspects such as medication adherence were not well-understood. Obstacles to effective T2DM self-management were negative interactions and communications with health care providers and other personnel, cultural stigma related to the disease, financial constraints, immigration status, and the complexity of the disease. Suggested interventions to improve the care and self-management of this at-risk population are discussed.
Fine Needle Aspiration Cytology of the Thyroid

OBJECTIVE To analyze the diagnostic efficacy of fine needle aspiration cytology (FNAC) in the initial evaluation of thyroid nodules, with special emphasis on discrepant cytologic diagnoses. STUDY DESIGN A total of 192 thyroid fine needle aspirates with subsequent histopathologic follow-up were analyzed. The cytologic diagnoses were divided into 4 categories: positive for malignancy, negative for malignancy, indeterminate for diagnosis and nondiagnostic. The detailed cytologic features were studied along with histopathology sections in all these cases by 2 observers (S.J. and P.D) independently. RESULTS Cytohistologic correlation was seen in 78.1% of cases and discordance in 21.9%. Indeterminate diagnoses accounted for 15.1% of cases. The majority of these were "follicular neoplasms. " The overall sensitivity was 84.44% and specificity 99.11 %. A false positive diagnosis was made in 1 case (0.5%), proven a follicular adenoma on histopathologic examination. A false negative diagnosis was seen in 3.6% of cases. These were cases of papillary microcarcinoma. CONCLUSION FNAC is a safe, sensitive and specific technique in the initial evaluation of thyroid nodules. A correct cytologic diagnosis can be achieved in a majority of cases, thus obviating the need for a second surgical intervention. A careful and diligent search for various cytologic features and accurate sampling can help in reducing the number of indeterminate, false positive and false negative diagnoses.
Precuneus degeneration in nondemented elderly individuals with APOE ɛ4: Evidence from structural and functional MRI analyses

Neurodegenerative diseases such as Alzheimer's disease (AD) have been recognized to exhibit disease‐specific brain vulnerability patterns. Apolipoprotein E (APOE) ɛ4 allele imparts a high genetic risk of developing AD. Whether the APOE ɛ4 allele damages the brain when cognitive functions are still intact is important to understand, especially for possible early detection and intervention. This study aimed to examine the selective degeneration pattern associated with the APOE ɛ4 allele in the brains of cognitively normal elderly subjects. We enrolled 35 cognitively healthy ɛ4 carriers and 40 non‐carriers (53 to 81 years old) to evaluate group differences in cortical thickness and brain activation during a memory‐encoding task. We also assessed the functional connectivity of the brain regions with both structural and functional damages. The results from the neuropsychological tests showed that the performances of ɛ4 carriers and non‐carriers were comparable. Primarily, we found that the precuneus exhibited thinner cortical thickness and decreased deactivation during memory encoding. Furthermore, the connectivity analyses show that carriers exhibited damaged connectivity of the precuneus to several regions in the default mode network and the attention/executive control network. Our study reveals the degeneration pattern of the ɛ4 allele, which could be used as a potential biomarker for early detection for possible interventions and treatments. Hum Brain Mapp 38:271–282, 2017. © 2016 Wiley Periodicals, Inc.
Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer.

OBJECTIVE Systematic sextant biopsies are a powerful tool in the diagnosis of prostate cancer. Interpretation of the histopathologic results of these biopsies plays a central role in treatment decisions. This biopsy approach was originally described as sampling the prostate in the mid-lobe, parasagittal plane at the apex, mid-gland, and base, bilaterally. Morphometric analysis of prostate specimens has revealed that most clinically significant cancers are mainly located in the posterolateral aspect of the gland, not the mid-lobe. We sought to determine if cancer detection could be improved by obtaining more laterally placed biopsies. MATERIALS AND METHODS Forty-one patients underwent transrectal ultrasound with mid-lobe sextant as well as lateral sextant biopsies. Biopsy specimens were evaluated for Gleason grade and length of cancer present in each core. The mid-lobe and lateral biopsy results were then compared. RESULTS Thirteen of 41 patients (31.7%) were found to have no cancer on either biopsy set. Cancer was detected by both the mid-lobe and the lateral biopsies in 19 patients (46.3%). In 6 patients (14.6%), only the lateral biopsies revealed cancer, and in 3 patients (7.3%), only the mid-lobe biopsies revealed cancer. CONCLUSIONS Laterally-placed systematic sextant biopsies may yield an improved diagnosis rate in patients with palpable nodularity in the lateral aspect of the prostate, patients without any palpable abnormalities but with elevated PSA levels, and in those patients undergoing repeat biopsies.
Outcomes of Women with Atypical Squamous Cells of Undetermined Significance and High-Risk Human Papillomavirus DNA

OBJECTIVE To study the risk of high-grade squamous intraepithelial lesion (HSIL) and cervical intraepithelial neoplasia (CIN) 2 or 3 in women with human papillomavirus (HPV)-positive atypical squamous cells of undetermined significance (ASCUS) cytology over a 2-year period using the 2001 Bethesda System and ThinPrep Paps. STUDY DESIGN In 2002, 846 patients with ThinPrep cervical cytology having an ASCUS interpretation and positive for high-risk HPV DNA were identified. A cohort of 514 (60.8%) patients with follow-up by repeat cytology, cervical biopsy or both was included in the study. Patient age was 12-81 years, with a median of 25 years. RESULTS There were 291 women (56.6%) with negative status by cytology, HPV testing or biopsy with a median interval of 8.5 months, and an additional 174 patients (33.9%) had persistent ASCUS, positive HPV DNA or low-grade SIL/CIN 1. Finally, 49 patients (9.5%) had CIN 2 or 3, with a median interval of 8.5 months. CONCLUSION Our study suggests that HSIL or CIN 2 or 3 will be detected in 1 in 10 women with HPV-positive index ASCUS cervical cytology at initial colposcopy or within a 2-year follow-up period.
Higher Ca2+‐sensitivity of arterial contraction in 1‐week‐old rats is due to a greater Rho‐kinase activity

During early post‐natal development, arterial contraction depends less on Ca2+‐signalling pathways but more on changes in Ca2+‐sensitivity compared to adult animals. Whether this difference is related to Rho‐kinase, one of the major players affecting Ca2+‐sensitivity, is unknown for intact vessels. Thus, we tested the hypothesis that Rho‐kinase critically contributes to the higher Ca2+‐sensitivity of contraction in intact arteries of 1‐week‐old rats.
Associations of Psychosocial and Individual Factors with Three Different Categories of Back Disorder among Nursing Staff

Associations of Psychosocial and Individual Factors with Three Different Categories of Back Disorder among Nursing Staff: Francesco S. Violante, et al. Alma Mater Studiorum—University of Bologna, Occupational Medicine Unit, Sant’Orsola‐Malpighi Hospital, Italy—Although back disorders are a major occupational problem for nursing staff, few studies distinguish different types. By means of a structured questionnaire, we performed a cross‐sectional study on the prevalence of diagnosed lumbar disc hernia, chronic low‐back pain (LBP) (at least 90 d in the preceding 12 months) and acute LBP (intense pain for at least 1 d) with respect to physical, individual and psychosocial factors among female nurses (n=587), nursing aides (n=228) and head‐nurses (n=43) working in a university hospital (95% of the female workforce). Almost all respondents reported known high‐risk occupational activities. Overall prevalence of reported back disorders was 44% (acute LBP 19%, chronic LBP 17%, lumbar hernia 8%). On multinomial logistic regression analysis, scoliosis and commonly stress‐related psychosomatic symptoms were associated with all three types of back disorder; trauma/ fractures of the spine, pelvis and/or legs and a global work‐environment/job‐satisfaction score with acute LBP; increasing age with lumbar disc hernia. While confirming the relevance of considering different definitions of back disorder, our data indicate items for investigation in cohort studies. These include: identification of specific risk factors for lumbar hernia; avoidance of possible work‐environment risk factors such as hurried execution of different tasks at the same time; and influence on job suitability of underlying spinal pathologies such as scoliosis.
Rolling Contact Fatigue Life and Spall Propagation of AISI M50, M50NiL, and AISI 52100, Part I: Experimental Results

This article is the first part of a three-part series that investigates the rolling contact fatigue (RCF) initiation and spall propagation characteristics of three bearing materials, namely, AISI 52100, VIM-VAR AISI M50, and VIM-VAR M50NiL steels. Although there is substantial prior work published on the rolling contact fatigue initiation of these materials, little has been published on their spall propagation characteristics after spall initiation. It is recognized that rapid spall growth can lead to catastrophic bearing failure. Hence, understanding the spall growth phase and factors that may cause accelerated growth rates is key to achieving a reliable and robust bearing design. The end goal is to identify control parameters for optimizing bearing materials for improved spall growth resistance. This first part study features the experimental results from 208-size (40 mm bore) angular-contact ball bearings endurance life tested at maximum Hertzian contact stress levels of 3.10 GPa and bearing outer race temperatures up to 131°C. Spall propagation experiments were conducted on new and life tested bearings at 2.10 and 2.41 GPa maximum contact stress. Spall propagation experiments show that all materials exhibit a rapid or critical spall growth rate after undergoing an initial low-rate spall growth period. The time-to-critical growth rate is dependent on contact stress and was swiftest in AISI 52100 steel. To better understand the underlying physics, the driving factors, and failure mechanisms, the state of stress is modeled using finite element analysis in Part II and an in-depth microstructural analysis of selected bearings is presented in Part III.
Spatial barriers impact upon appropriate delivery of radiotherapy in breast cancer patients

Radiotherapy (RT) is the standard treatment for breast cancer patients after conserving surgery or mastectomy when patients are at high risk of relapse. Major obstacles to appropriate RT delivery are journey times. Since studies on access to RT were carried out mostly in large countries, this study investigated factors in an Italian region and the influence of RT delivery on survival. A total of 4735 female candidates for RT were included in the study. A geographic information system calculated journey times from patients' homes and surgery hospitals to RT centers. Logistic regression analyzed the influence of journey times, socioeconomic status, and other factors on RT delivery. Survival probabilities and excess mortality were assessed in 4364 propensity score‐matched patients. Journey times of 40 min or less from residence and from surgery hospital to RT center played a major role in access to RT. A large survival difference emerged between treated and untreated breast cancer patients. The excess mortality for untreated patients compared with propensity score‐matched women receiving RT was 3.1 (95% CI: 2.2–4.3). Expansion of RT facilities during the 11‐year study period improved RT delivery and outcomes by increasing availability but mainly by shortening journey times.
The Effects of Acupressure on Meridian Energy as well as Nausea and Vomiting in Lung Cancer Patients Receiving Chemotherapy

Nausea and vomiting are the most common side effects of antineoplastic chemotherapy. However, only a small number of studies have been conducted in Taiwan to determine the efficacy of acupressure in treating these side effects in cancer patients receiving chemotherapy. In this quasi-experimental study, we aimed to explore the effects of acupressure on meridian energy as well as nausea and vomiting in 70 lung cancer patients receiving chemotherapy. Patients were assigned to the experimental or control group based on order of hospital admission. The experimental group received acupressure on “Neiguan (PC6)” and “Gongsun (SP4)” points, and the control group received sham acupoint patches on “Houxi (SI3)” point. The results showed that the mean meridian energy in the experimental group after acupressure was significantly higher than in the control group (F = 28.71, p < .001). The experimental group had significantly less nausea (p < .001) and vomiting (p = .006) during the delayed phase than the control group. In conclusion, acupressure significantly increased the mean meridian energy and effectively decreased the severity of nausea and vomiting in lung cancer patients undergoing chemotherapy. We recommend that clinical nurses provide acupressure as an intervention to relieve nausea and vomiting in patients receiving chemotherapy.
A review of measles supplementary immunization activities and the implications for Pacific Island countries and territories

ABSTRACT Introduction: Standard measles control strategies include achieving high levels of measles vaccine coverage using routine delivery systems, supplemented by mass immunization campaigns as needed to close population immunity gaps. Areas covered: This review looks at how supplementary immunization activities (SIAs) have contributed to measles control globally, and asks whether such a strategy has a place in Pacific Islands today. Expert commentary: Very high coverage with two doses of measles vaccine seems to be the optimal strategy for controlling measles. By 2015, all but two Pacific Islands had introduced a second dose in the routine schedule; however, a number of countries have not yet reached high coverage with their second dose. The literature and the country reviews reported here suggest that a high coverage SIA combined with one dose of measles vaccine given in the routine system will also do the job. The arguments for and against the use of SIAs are complex, but it is clear that to be effective, SIAs need to be well designed to meet specific needs, must be carried out effectively and safely with very high coverage, and should, when possible, carry with them other public health interventions to make them even more cost-effective.
Transport of peritoneal membrane assessed before and after the start of peritoneal dialysis.

BACKGROUND Patients on peritoneal dialysis (PD) with high small solute peritoneal membrane transport have an increased risk of morbidity and mortality. The membrane transport is currently assessed by peritoneal equilibration test (PET), usually performed after the first month of PD because of the early increase of membrane transport after the start of PD. The aim of this study was the assessment of small solute peritoneal membrane transport before and after the start of PD. METHODS The small solute peritoneal membrane transport was evaluated in 34 patients before the start of PD. Twenty-two patients were treated with continuous ambulatory peritoneal dialysis (CAPD) and 12 with automated peritoneal dialysis (APD). RESULTS Four months after the start of PD, the small solute peritoneal membrane transport increased only in CAPD patients (D/P(Creat), the ratio between dialysate solute concentration at the end of the PET and creatinine plasma concentration, changed from 0.66 +/- 0.12 to 0.73 +/- 0.07 in CAPD patients and from 0.64 +/- 0.12 to 0.61 +/- 0.07 in APD patients), and after about 16 months of PD, the peritoneal membrane transport was higher in CAPD patients (D/P(Creat) = 0.74 +/- 0.06) than in APD patients (D/P(Creat) = 0.63 +/- 0.10). CONCLUSIONS Performing the PET before and after the start of PD could provide relevant information about the characteristics of small solute peritoneal membrane transport and could be useful to evaluate the influence of PD modality on the changes in peritoneal membrane transport.
Nucleus accumbens and caudate atrophy predicts longer action selection times in young and old adults

There is a convergence in the literature toward a critical role for the basal ganglia in action selection. However, which substructures within the basal ganglia fulfill this role is still unclear. Here we used shape analyses of structural magnetic resonance imaging data to determine the extent to which basal ganglia structures predict performance in easy and complex multilimb reaction‐time tasks in young and old adults. Results revealed that inward deformation (i.e., local atrophy) of the nucleus accumbens and caudate were predictive of longer action selection times in complex conditions, but not in easy conditions. Additionally, when assessing the relation between behavioral performance and the shape of the left nucleus accumbens in the two age groups separately, we found a significant performance–structure association in old, but not young adults. This result suggests that the relevance of the nucleus accumbens for the process of action selection increases with age. Hum Brain Mapp 37:4629–4639, 2016. © 2016 Wiley Periodicals, Inc.
Role of Fine Needle Aspiration Cytology, Cell Block Preparation and CD63, P63 and CD56 Immunostaining in Classifying the Specific Tumor Type of the Lung

OBJECTIVE To determine whether CD63, p63 and CD56 are useful in the diagnostic evaluation of cytologic samples of pulmonary malignancy. STUDY DESIGN We explored the utility of using a panel of 3 antibodies, CD63, p63 and CD56, for the diagnosis of lung cancer in cytologic samples consisting of 40 cases of cell block sections and previously Papanicolaou-stained cytologic smear slides. RESULTS The positive rates for CD63, p63 and CD56 were as follows: adenocarcinoma (18/19), (0/19), (0/19), for small cell lung carcinoma (3/8), (0/8), (8/8), and for squamous cell carcinoma (0/13), (12/13), (0/13). All p63 positive cases were squamous cell carcinoma, and all CD56 positive cases were small cell lung carcinoma. CD63 was positive in the majority of adenocarcinomas. CONCLUSION The panel of CD63, p63 and CD56 appears to be useful in the diagnostic evaluation of cytologic samples of pulmonary malignancy.
Comparative Assessment of Two Constitutive Models for Superelastic Shape-Memory Wires Against Experimental Measurements

Two constitutive models representative of two well-known modeling techniques for superelastic shape-memory wires are reviewed. The first model has been proposed by Kim and Aberayatne in the framework of finite thermo-elasticity with non-convex energy [1]. In the present article this model has been modified in order to take into account the difference between elastic moduli of austenite and martensite and to introduce the isothermal approximation proposed in [1]. The second model has been developed by Auricchio et al. within the theory of irreversible thermodynamics with internal variables [2]. Both models are temperature and strain rate dependent and they take into account thermal effects. The focus in this article is on investigating how the two models compare with experimental data obtained from testing superelastic NiTi wires used in the design of a prototypal anti-seismic device [3, 4]. After model calibration and numerical implementation, numerical simulations based on the two models are compared with data obtained from uniaxial tensile tests performed at two different temperatures and various strain rates.
Symptoms and impact of COPD assessed by an electronic diary in patients with moderate-to-severe COPD: psychometric results from the SHINE study

Background Symptoms, particularly dyspnea, and activity limitation, have an impact on the health status and the ability to function normally in patients with chronic obstructive pulmonary disease (COPD). Methods To develop an electronic patient diary (eDiary), qualitative patient interviews were conducted from 2009 to 2010 to identify relevant symptoms and degree of bother due to symptoms. The eDiary was completed by a subset of 209 patients with moderate-to-severe COPD in the 26-week QVA149 SHINE study. Two morning assessments (since awakening and since the last assessment) and one evening assessment were made each day. Assessments covered five symptoms (“shortness of breath,” “phlegm/mucus,” “chest tightness,” “wheezing,” and “coughing”) and two impact items (“bothered by COPD” and “difficulty with activities”) and were scored on a 10-point numeric scale. Results Patient compliance with the eDiary was 90.4% at baseline and 81.3% at week 26. Correlations between shortness of breath and impact items were >0.95. Regression analysis showed that shortness of breath was a highly significant (P<0.0001) predictor of impact items. Exploratory factor analysis gave a single factor comprising all eDiary items, including both symptoms and impact items. Shortness of breath, the total score (including five symptoms and two impact items), and the five-item symptom score from the eDiary performed well, with good consistency and reliability. The eDiary showed good sensitivity to change, with a 0.6 points reduction in the symptoms scores (on a 0–10 point scale) representing a meaningful change. Conclusion The eDiary was found to be valid, reliable, and responsive. The high correlations obtained between “shortness of breath” and the ratings of “bother” and “difficulty with activities” confirmed the relevance of this symptom in patients with COPD. Future studies will be required to explore further psychometric properties and their ability to differentiate between COPD treatments.