Miracle-dz/UniFAR-FTUs huggingface dataset:
Fibrosis assessment in chronic hepatitis C--is the liver biopsy still necessary? The pathologist point of view.

AIM The aim of this study was to compare the histological stage of fibrosis determined by liver biopsy with the stage of fibrosis assessed by Fibroscan, to analyze the correspondences and inconsistencies between obtained values and to discuss the role of the microscopic exam, from the pathologist point of view. MATERIAL AND METHODS The study group consisted of 185 patients diagnosed with chronic hepatitis. Serological tests diagnosed chronic hepatitis C in 183 patients, and chronic hepatitis B and C for 2 patients. The patients were evaluated to determine the stage of fibrosis using two methods: liver biopsy and elastography (Fibroscan). RESULTS Based on the pathologic evaluation, 124 cases were diagnosed as moderate chronic hepatitis (score 6-8), and the remaining 60 cases as severe hepatitis (score 9-12). Comparison of data from examination of liver biopsy with that obtained by Fibroscan examination revealed overlapping and divergent aspects. The fibrosis stage established through liver biopsy did not always coincide with the one assigned by liver stiffness measurement, particularly for intermediate stages F2 and F3. The best overlap was noted for F0-F1 and F4 stages, which indicates the evident ability of transient elastography to separate patients with minimal or no fibrosis from patients with extensive fibrosis. CONCLUSIONS Our data concurs with the literature, which confirms presence of differences between Fibroscan and biopsy. From the point of view of the pathologist, liver biopsy still remains a valuable instrument, offering a relevant image of liver changes--as it is regarded more rather a selective than routine technique.
The Australian drug harms ranking study

Background/Aim: The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions. Method: A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the individual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool. Results: MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal methamphetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal methamphetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal methamphetamine, cannabis, heroin and pharmaceutical opioids. Conclusions: The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and methamphetamine should be a priority.
ParkinSong: A Controlled Trial of Singing-Based Therapy for Parkinson’s Disease

Background. Communication impairment is one of the most common symptoms of Parkinson’s disease (PD), significantly affecting quality of life. Singing shares many of the neural networks and structural mechanisms used during speech and, thus, has potential for therapeutic application to address speech disorders. Objective. To explore the effects of an interdisciplinary singing-based therapeutic intervention (ParkinSong) on voice and communication in people with PD. Methods. A controlled trial compared the effects of the ParkinSong intervention with an active control condition at 2 dosage levels (weekly vs monthly) over 3 months, on voice, speech, respiratory strength, and voice-related quality-of-life outcomes for 75 people living with PD. The interdisciplinary ParkinSong model comprised high-effort vocal and respiratory tasks, speech exercises, group singing, and social communication opportunities. Results. ParkinSong intervention participants demonstrated significant improvements in vocal intensity (P = .018), maximum expiratory pressure (P = .032), and voice-related quality of life (P = .043) in comparison to controls. Weekly ParkinSong participants increased vocal intensity more than monthly participants (P = .011). Vocal intensity declined in nontreatment control groups. No statistical differences between groups on maximum phonation length or maximum inspiratory pressure were observed at 3 months. Conclusions. ParkinSong is an engaging intervention with the potential to increase loudness and respiratory function in people with mild to moderately severe PD.
What Do Germans Want to Know About Skin Cancer? A Nationwide Google Search Analysis From 2013 to 2017

Background Experts worldwide agree that skin cancer is a global health issue, but only a few studies have reported on world populations’ interest in skin cancer. Internet search data can reflect the interest of a population in different topics and thereby identify what the population wants to know. Objective Our aim was to assess the interest of the German population in nonmelanoma skin cancer and melanoma. Methods Google AdWords Keyword Planner was used to identify search terms related to nonmelanoma skin cancer and melanoma in Germany from November 2013 to October 2017. The identified search terms were assessed descriptively using SPSS version 24.0. In addition, the search terms were qualitatively categorized. Results A total of 646 skin cancer-related search terms were identified with 19,849,230 Google searches in the period under review. The search terms with the highest search volume were “skin cancer” (n=2,388,500, 12.03%), “white skin cancer” (n=2,056,900, 10.36%), “basalioma” (n=907,000, 4.57%), and “melanoma” (n=717,800, 3.62%). The most searched localizations of nonmelanoma skin cancer were “nose” (n=93,370, 38.99%) and “face” (n=53,270, 22.24%), and the most searched of melanoma were “nails” (n=46,270, 70.61%) and “eye” (n=10,480, 15.99%). The skin cancer‒related category with the highest search volume was “forms of skin cancer” (n=10,162,540, 23.28%) followed by “skin alterations” (n=4,962,020, 11.36%). Conclusions Our study provides insight into terms and fields of interest related to skin cancer relevant to the German population. Furthermore, temporal trends and courses are shown. This information could aid in the development and implementation of effective and sustainable awareness campaigns by developing information sources targeted to the population’s broad interest or by implementing new Internet campaigns.
The Relationship Between Tobacco Smoking, Cortisol Secretion, and Sleep Continuity

Abstract Background: Existing theories hold that chronic tobacco smoking leads to the development of adverse psychological symptoms, thus producing a compulsive urge to smoke in order to alleviate these sensations. Sleep disturbances are often considered among the negative consequences of chronic smoking. Objectives: The current study aimed at examining whether dysregulation of the hypothalamic-pituitary-adrenocortical (HPA) axis may be involved in this disruption of sleep quality among smokers. Methods: Smokers and non-smokers provided saliva samples following awakening for assessment of cortisol concentrations as a measure of HPA activity. Subsequently the participants completed the State-Trait Anxiety Inventory, Brief Questionnaire on Smoking Urges, the Fagerstrom Test for Nicotine Dependence, and the Pittsburgh Sleep Quality Index. Next, their sleep was monitored objectively for one week using an actigraph. Results: While smokers' self-reported sleep quality was similar to that of non-smokers, their sleep recording data pointed to diminished sleep continuity (increased wake time after sleep onset; WASO), while total sleep time and sleep onset latency were similar to that of non-smokers. Cortisol secretion was higher among smokers. However, among smokers only, cortisol was negatively correlated with WASO, suggesting that the direct enhancing effect of smoking on WASO is somewhat balanced by an indirect process related to higher cortisol levels. Possible interpretations for this inconsistent mediation are discussed. Conclusions/Importance: Smoking is associated with reduced sleep continuity and the relationship between smoking and sleep continuity may involve the HPA axis.
A macro-finance approach to the term structure of interest rates

This thesis contributes to the literature that analyses the term structure of interest rates from a macroeconomic perspective. Chapter 1 studies the transmission of monetary policy shocks to the US macroeconomy and term structure. Based on estimates of a Macro-Affine model, it shows that monetary policy shocks trigger relevant movements in bond premia, which in turn feed back into the macroeconomy. This channel of monetary transmission shows up importantly in the pre-Volcker period, but becomes irrelevant later. This chapter concludes with an analysis of the macroeconomic implications of shocks to expectations about future monetary policy actions. Chapter 2 proposes a regime-switching approach to explain why the U.S. nominal yield curve on average has been steeper since the mid-1980s than during the Great Inflation of the 1970s. It shows that, once the possibility of regime switches in the short-rate process is incorporated into investors' beliefs, the average slope of the yield curve generally will contain a new component called 'level risk'. Level risk estimates were found to be large and negative during the Great Inflation, but became moderate and positive afterwards. These findings are replicated in a Markov-Switching DSGE model, where the monetary policy rule shifts between an active and a passive regime with respect to inflation fluctuations. Chapter 3 develops a DSGE model in which banks use short-term deposits to provide firms with long-term credit. The demand for long-term credit arises because firms borrow in order to finance their capital stock which they only adjust at infrequent intervals. The model shows that maturity transformation in the banking sector in general attenuates the output response to a technological shock. Implications of long-term nominal contracts are also examined in a New Keynesian version of the model. In this case, maturity transformation reduces the real effects of a monetary policy shock.
Photometric Analysis of Propolis from the Island of Samothraki, Greece. The Discovery of Red Propolis

Propolis presents notable and variable antioxidant activity depending on the territory and the local flora. As a result, propolis collected from areas presenting botanical diversity can become an intriguing research field. In the present study, we examined propolis from different areas of Samothraki, a small Greek island in the north‐eastern Aegean Sea, considered a hot‐spot of plant biodiversity. The analysis of propolis samples presented huge variability in the antioxidant activity, the total polyphenol content and the total flavonoids content. Propolis from two areas presented high antioxidant activity with a maximum at 1741.48 μmol of Trolox equivalents per gram of dry propolis weight, very high polyphenol content, 378.73 mg of gallic acid equivalents per gram of dry propolis weight, and high flavonoid content with a maximum concentration of 70.31 mg of quercetin equivalents per gram of dry propolis weight. The samples that presented the best qualitative characteristics were all red propolis which is a type that has never been reported in any part of Europe.
Surgery results using different uterine wall incision directions in laparoscopic myomectomy of the intramural myoma

ObjectiveTo study clinical outcomes for different uterine wall incision directions, comparing vertical incision and transverse incision in laparoscopic myomectomy of the intramural myoma.MethodsLaparoscopic myomectomies were performed on 50 women with intramural myomas. Using a table of random numbers, they were randomly divided into a vertical incision group (25 women) and a transverse incision group (25 women) according to the direction of incisions in the uterine wall. The numbers of enucleated myoma, operation duration, amount of bleeding, and numbers of sutures were compared. The Mann-WhitneyU-test was used for analysis.ResultsFor the transverse incision group, the amount of bleeding (137.6 ± 88.1 mL) was a significantly lower value (P = 0.0426) than for the vertical incision group (235.8 ± 169.4 mL). In addition, in cases where the maximum myoma nucleus diameter was 7 cm or larger, operation duration (129.0 ± 32.5 min) and amount of bleeding (158.9 ± 87.1 mL) showed significantly lower values (P = 0.0067 andP = 0.0002, respectively) for the transverse incision group than did operation duration (362.3 ± 147.3 min) and amount of bleeding (362.3 ± 147.3 mL) for the vertical incision group.ConclusionTransverse incision of the uterine wall is useful to reduce the amount of bleeding in the laparoscopic myomectomy of the intramural myoma. Transverse incision also shortens operation duration in cases where the myoma nuclei are large.
A role for SPEECHLESS in the integration of leaf stomatal patterning with the growth vs disease trade-off in poplar.

Occurrence of stomata on both leaf surfaces (amphistomaty) promotes higher stomatal conductance and photosynthesis while simultaneously increasing exposure to potential disease agents in black cottonwood (Populus trichocarpa). A genome-wide association study (GWAS) with 2.2M SNPs generated through whole genome sequencing found 280 loci associated with variation in adaxial stomatal traits, implicating genes regulating stomatal development and behaviour. Strikingly, numerous loci regulating plant growth and response to biotic and abiotic stresses were also identified. The most significant locus was a poplar homolog of SPEECHLESS (PtSPCH1). Individuals possessing PtSPCH1 alleles associated with greater adaxial stomatal density originated primarily from environments with shorter growing seasons (e.g. northern latitudes, high elevations) or with less precipitation. PtSPCH1 was expressed in developing leaves but not developing stem xylem. In developing leaves, RNA-seq showed patterns of co-ordinated expression between PtSPCH1 and other GWAS-identified genes. The breadth of our GWAS results suggests that the evolution of amphistomaty is part of a larger, complex response in plants. Suites of genes underpin this response, retrieved through genetic association to adaxial stomata, and show co-ordinated expression during development. We propose that the occurrence of amphistomaty in P. trichocarpa involves PtSPCH1 and reflects selection for supporting rapid growth over investment in immunity. This article is protected by copyright. All rights reserved.
Prevalence and documented causes of hyponatraemia among geriatric patients attending a primary care clinic.

INTRODUCTION Hyponatraemia is the commonest electrolyte abnormality and has major clinical implications. However, few studies of hyponatraemia in the primary care setting has been published to date. OBJECTIVES To determine the prevalence, potential causes and management of hyponatraemia and to identify factors associated with severity of hyponatraemia among older persons in a primary care setting. METHODS Electronic records were searched to identify all cases aged ≥60 years with a serum sodium <135mmol/l, attending outpatient clinic in 2014. Patients' medical records with the available blood test results of glucose, potassium, urea and creatinine were reviewed. RESULTS Of the 21,544 elderly, 5873 patients (27.3%) had electrolyte profile tests. 403 (6.9%) had hyponatraemia in at least one blood test. Medical records were available for 253, mean age 72.9±7.3 years, 178 (70.4%) had mild hyponatraemia, 75 (29.6%) had moderate to severe hyponatraemia. Potential causes were documented in 101 (40%). Patients with moderate to severe hyponatraemia were five times more likely to have a cause of hyponatraemia documented (p<0.01). Medications were the commonest documented cause of hyponatraemia (31.7%). Hydrochlorothiazide use was attributed in 25 (78.1%) of 32 with medication-associated hyponatraemia. Repeat renal profile (89%) was the commonest management of hypotonic hyponatraemia. CONCLUSION Whilst hyponatraemia was common in the clinic setting, many cases were not acknowledged and had no clear management strategies. In view of mild hyponatraemia has deleterious consequences, future studies should determine whether appropriate management of mild hyponatraemia will lead to clinical improvement.
Perceptions of School Based Mental Health Services by Directors and Supervisors of Student Services

vii Chapter One: Introduction 1 Statement of Problem 1 Rationale 9 Purpose of Study 10 Research Questions 11 Significance of Study 12 Definition of Terms 12 Chapter Two: Review of the Literature 14 Introduction 14 Defining Mental Health Services 14 The Historical Background of Child Mental Health 16 Lack of Mental Health Services for Children 18 Mental Health and Student Outcomes 20 Importance of Mental Health Services in Schools 24 Role of School Psychologist, Counselor and Social Worker and Mental Health in Schools 26 Summary 34 Chapter Three: Method 36 Participants 36 Selection of Participants 36 Research Design 37 Instrumentation 37 Procedure 39 Step One: Selection of Participants 39 Step Two: Data Collection 40 Step Three: Data Management 40 Data Analysis 41 Chapter Four: Results 48 Survey Response Rate 49 Description of the Sample 51 Description of Districts 54 Research Questions 58 Research Question 1 58 Research Question 2 63
Phosphorylated mTORC1 represses autophagic‐related mRNA translation in neurons exposed to ischemia‐reperfusion injury

The sequential reactivation of mechanistic target of rapamycin (mTOR) inhibited autophagic flux in neurons exposed to oxygen‐glucose deprivation/reperfusion (OGD/R), which was characterized by reduction of autophagosome formation and restriction of autolysosome degradation. However, its detailed molecular mechanism was still unknown. In this study, we further explore the existing form of mTOR and its suppression on the transcriptional levels of related mRNA from neurons exposed to ischemia‐reperfusion injury.
Efficacy and safety of immune checkpoint inhibitors in a Danish real life non-small cell lung cancer population: a retrospective cohort study

Abstract Background: To investigate effect and toxicity of immune checkpoint inhibition (ICI) in a Danish real-life non-small cell lung cancer (NSCLC) population. By including patients underrepresented in clinical trials, such as those with brain metastasis (BM), higher age, more comorbidity and poorer performance status (ECOG), comparison of unselected patients to clinical trial populations is possible. Material and methods: Real life data were gathered from 118 consecutive NSCLC patients with incurable NSCLC treated with ICI at the Department of Oncology at the University Hospital of Odense, Denmark from September 2015 to April 2018. Immune-related adverse events (irAEs) grades 3–5 were registered prospectively during the same period. Additional patient related data were obtained retrospectively from patients' files. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan–Meier estimates, the log-rank test and cox regression analysis performed for factors affecting survival. Results: Median age for patients was 66 years (IQR 59–71) and 62 years (range: 55–64) for those with BM. Females 63%; adenocarcinoma (AC)/squamous/others 69%/23%/8%; ECOG ≥ 2 10%; bone/brain/liver metastases 36%/18%/15%; PD-L1 (TPS) <1%/ ≥ 1%/ ≤ 49%/ ≥ 50%/NR: 3%/14%/68%/15%; baseline autoimmunity 10%, Charlson's Comorbidity Index Score (CCIS) ≥ 2 39%, treatment line: 1st/2nd/ ≥ 3rd 39%/30%/31%. Median OS for patients receiving ICI in ≥2 line was 11.5 months versus not reached in first line (HR 2.6, [95% CI: 1.3–5.0], p = .005). For patients with BM, the median OS was 8.2 months (HR 1.38, [95% CI: 0.7–2.5], p = .37). Twenty-four percent of patients terminated ICI due to irAE grades 3–5 alone (grade 5, n = 1), which were not associated with higher age or BM. Conclusions: OS and PFS were comparable to clinical trial reports. Long-lasting remission is also possible in patients with BM. Real-life populations have higher rates of irAE grades 3 and 4 than reported in clinical trials, but it does not seem to impact median OS.
A Randomized, Placebo-Controlled, Crossover Pilot Trial of the Oral Selective NR2B Antagonist MK-0657 in Patients With Treatment-Resistant Major Depressive Disorder

Abstract Converging lines of evidence suggest that the glutamatergic system may play an increasingly important role in the development of novel therapeutics for major depressive disorder (MDD), particularly agents associated with rapid antidepressant effects. Diverse glutamatergic modulators targeting N-methyl-D-aspartate receptors have shown efficacy in MDD, but their associated psychotomimetic effects presently preclude their use in larger samples. This small, randomized, double-blind, placebo-controlled, crossover pilot study evaluated the potential antidepressant efficacy and tolerability of an oral formulation of the selective N-methyl-D-aspartate NR2B antagonist MK-0657 in patients with treatment-resistant MDD (TRD). The TRD subjects underwent a 1-week drug-free period and were subsequently randomized to receive either MK-0657 monotherapy (4–8 mg/d) or placebo for 12 days. Because of recruitment challenges and the discontinuation of the compound’s development by the manufacturer, only 5 of the planned 21 patients completed both periods of the crossover administration of MK-0657 and placebo. Significant antidepressant effects were observed as early as day 5 in patients receiving MK-0657 compared with those receiving placebo, as assessed by the Hamilton Depression Rating Scale and Beck Depression Inventory; however, no improvement was noted when symptoms were assessed with the Montgomery-Asberg Depression Rating Scale, the primary efficacy measure. No serious or dissociative adverse effects were observed in patients receiving this oral formulation of MK-0657. Despite the small sample size, this pilot study suggests that an oral formulation of the NR2B antagonist MK-0657 may have antidepressant properties in TRD patients. Further studies with larger sample sizes are necessary to confirm these preliminary findings.