Miracle-dz/UniFAR-FTUs huggingface dataset:
[Evaluation of the action « M'T Dents » for 6-year-old schoolchildren on two deprived neighborhoods in Marseille, France].

Background This study aims to analyze the effects of the national program for individual dental prevention "M'T Dents" to 6-years-old children living in the neighborhoods of deprived areas Saint-Mauront and Belle de Mai from 2009 to 2012 (Marseille, France). These children having received an additional collective awareness and individual monitoring as part of the experimental program of health promotion "La Santé à Saint Mauront - Belle de Mai: on s’y met tous! " led by the PACA Regional Health Agency. Materials and Methods Awareness sessions in oral hygiene were led in CP grades of 5 schools and each child was then followed and encouraged to resort to dentist. Data on the use of the bucco-dental examination (BDE), the use of consecutive care and the oral health status of children were collected. Results Of the three years considered by this study, 56 classes and more than 1000 children were involved by this prevention program. The average use of BDE was 27.70%. Among children who received the BDE, 44.33% required treatment, approximately 26% with 1-3 untreated caries, 12%: 4-6 caries and 6%: 7 caries or more. Nearly 60% were completely cured, 15% partially and 25% not treated within 6 months following the BDE. Care utilization varied by initial caries index: the percentage of children fully treated was significantly higher for children with 1-3 caries than those with 4-6 caries (p <0.05) and those with 7 caries or more (p < 0.001) when the BDE. Conclusion Modes of action that are reinforced in this territory seem possible to achieve results comparable to those observed in the same age group at the national level for children. More children were able to use the dentist and receive consecutive care under this program contributes to reducing inequalities in oral health.
Comparing the Effect of Oral Clonidine and Tranexamic Acid on Bleeding and Surgical Field Quality during Functional Endoscopic Sinus Surgery

Introduction: Bleeding during functional endoscopic sinus surgery (FESS) is an important issue for both anesthesiologists and surgeons as it can affect the safety and efficiency of the procedure. We compared the efficacy of tranexamic acid (TXA) and clonidine in reducing blood loss and improving surgical field visualization during FESS. Materials and Methods: In a double-blind, randomized, clinical trial, 52 patients, American Society of Anesthesiologists (ASA) physical status 1–2, aged 13–75 years, suffering from rhinosinusitis with or without polyposis, and who were candidates for FESS, were enrolled. The first group received intravenous TXA 15 mg/kg diluted in 100 ml normal saline, administered during 10-min infusion after induction. In the second group, 0.2 mg oral clonidine was given 1 to 1.5 hours before surgery. Duration of surgery, hemoglobin level, heart rate, blood pressure, and quality of surgical field based on Boezzart's scale and surgeon satisfaction based on Likert's scale were recorded in both groups. Results: In total, 52 patients, 27 (51.9%) males and 25 (48.07%) females were studied. Twenty-two (42.3%) and 30 (57.7%) were in the TXA and clonidine groups, respectively. The mean pre- and post-surgical hemoglobin level showed no meaningful difference between the two groups. The same result was obtained for blood pressure and heart rate at different time points (P>0.05). Mean anesthesia time (P=0.859), mean surgical time (P=0.880), surgeon's satisfaction of the surgical field (P=0.757) and surgical field quality at different time points revealed no significant difference between the two groups. Conclusion: Premedication with oral clonidine and intravenous TXA has the same effect on bleeding during FESS, surgical field visualization, and surgeon satisfaction.
Prevalence of Complementary Medicine Use in Patients With Cancer: A Turkish Comprehensive Cancer Center Experience

Purpose Complementary and alternative medicine (CAM) has been popular among patients with cancer for several decades. The objectives of this study were to evaluate the prevalence of CAM use and to identify the factors affecting CAM use in a large patient cohort seen at a comprehensive cancer center in Turkey. Patients and Methods An investigator-designed survey was completed by volunteer patients who visited the outpatient clinic in the medical oncology department. CAM use encompassed pharmacologic agents including vitamins, dietary supplements, and herbal products or nonpharmacologic methods like prayer, meditation, hypnosis, massage, or acupuncture. Results Of 1,499 patients who answered the survey, 1,433 (96%) used nonpharmacologic CAM and 60 (4%) used pharmacologic CAM (pCAM). The most frequent types of CAM used were prayer (n = 1,433) followed by herbal products (n = 42). pCAM use was not significantly associated with age (P = .63), sex (P = .15), diagnosis (P = .15), or income level (P = .09). However, it was significantly associated with the level of education (P = .0067) and employment status (P < .001). Patients with higher education levels used more pCAM products (P = .025). Among 60 pCAM users, six patients (10%) used pCAM for more than 2 years and 22 (36%) did not consult their physicians about their pCAM use. Only nine patients (15%) reported unpleasant adverse effects related to pCAM. Conclusion Although CAM use was high among our patients, prevalence of pCAM use was lower than expected. Patients with higher education levels tended to use more pCAM.
Lung Protection Strategies during Cardiopulmonary Bypass Affect the Composition of Bronchoalveolar Fluid and Lung Tissue in Cardiac Surgery Patients

Pulmonary dysfunction is among the most frequent complications to cardiac surgeries. Exposure of blood to the cardiopulmonary bypass (CPB) circuit with subsequent lung ischemia-reperfusion leads to the production of inflammatory mediators and increases in microvascular permeability. The study aimed to elucidate histological, cellular, and metabolite changes following two lung protective regimens during CPB with Histidine-Tryptophan-Ketoglutarate (HTK) enriched or warm oxygenated blood pulmonary perfusion compared to standard regimen with no pulmonary perfusion. A total of 90 patients undergoing CPB were randomized to receiving HTK, oxygenated blood or standard regimen. Of these, bronchoalveolar lavage fluid (BALF) and lung tissue biopsies were obtained before and after CPB from 47 and 25 patients, respectively. Histopathological scores, BALF cell counts and metabolite screening were assessed. Multivariate and univariate analyses were performed. Profound histological, cellular, and metabolic changes were identified in all patients after CPB. Histological and cellular changes were similar in the three groups; however, some metabolite profiles were different in the HTK patients. While all patients presented an increase in inflammatory cells, metabolic acidosis, protease activity and oxidative stress, HTK patients seemed to be protected against severe acidosis, excessive fatty acid oxidation, and inflammation during ischemia-reperfusion. Additional studies are needed to confirm these findings.
Serum cytokines profile in treated celiac disease compared with non-celiac gluten sensitivity and control: a marker for differentiation.

BACKGROUND AND AIMS There is increasing evidence regarding elevated serum levels of inflammatory cytokines in patients with celiac disease (CD), but little is known about their levels in patients with non-celiac gluten sensitivity (NCGS). The aim of this study was to evaluate the serum levels of inflammatory cytokines in Iranian patients with CD and NCGS and to compare them with those of healthy individuals. METHODS A total of 110 treated CD, 15 with NCGS, and 46 healthy subjects were enrolled during 2016. Serum levels of IL-1, IL-6, IL-8, IL-15 and IFN-γ were measured using ELISA, and compared between groups. The correlation of the severity of mucosal damage and clinical symptoms with serum levels of cytokines was also assessed. RESULTS The mean serum levels of IFN-γ (p = 0.04) and IL-6 (p = 0.007) were significantly different between the patients in the CD and control groups, and IL-8 was significantly higher in the CD group compared with patients in the NCGS group (p = 0.04). Statistically significant correlations were observed between the serum levels of IFN-γ and abortion (p = 0.01), IL-1 and weight loss (p = 0.043) and infertility (p = 0.0001) in CD patients, and between IFN-γ and abortion (p = 0.01) and infertility (p = 0.01) in the NCGS patients. Moreover, no significant relationship was observed between the severity of mucosal damage and the serum level of the studied cytokines. CONCLUSIONS Inflammatory cytokines are implicated in the pathogenesis of CD, and their serum levels might help to identify a diagnostic marker to differentiate CD from NCGS. However, further studies with a larger sample size are recommended.
Bicuspid aortic valve formation: Nos3 mutation leads to abnormal lineage patterning of neural crest cells and the second heart field

ABSTRACT The bicuspid aortic valve (BAV), a valve with two instead of three aortic leaflets, belongs to the most prevalent congenital heart diseases in the world, occurring in 0.5-2% of the general population. We aimed to understand how changes in early cellular contributions result in BAV formation and impact cardiovascular outflow tract development. Detailed 3D reconstructions, immunohistochemistry and morphometrics determined that, during valvulogenesis, the non-coronary leaflet separates from the parietal outflow tract cushion instead of originating from an intercalated cushion. Nos3−/− mice develop a BAV without a raphe as a result of incomplete separation of the parietal outflow tract cushion into the right and non-coronary leaflet. Genetic lineage tracing of endothelial, second heart field and neural crest cells revealed altered deposition of neural crest cells and second heart field cells within the parietal outflow tract cushion of Nos3−/− embryos. The abnormal cell lineage distributions also affected the positioning of the aortic and pulmonary valves at the orifice level. The results demonstrate that the development of the right and non-coronary leaflets are closely related. A small deviation in the distribution of neural crest and second heart field populations affects normal valve formation and results in the predominant right-non-type BAV in Nos3−/− mice. Summary: The endothelial Nos3 mutation impacts neural-crest and second-heart-field lineage patterning within the aortic valve, which affects outflow-tract formation, as well as aortopulmonary angulation.
Identifying a neuroanatomical signature of schizophrenia, reproducible across sites and stages, using machine learning with structured sparsity

Structural MRI (sMRI) increasingly offers insight into abnormalities inherent to schizophrenia. Previous machine learning applications suggest that individual classification is feasible and reliable and, however, is focused on the predictive performance of the clinical status in cross‐sectional designs, which has limited biological perspectives. Moreover, most studies depend on relatively small cohorts or single recruiting site. Finally, no study controlled for disease stage or medication's effect. These elements cast doubt on previous findings’ reproducibility.
Recent intensification of Amazon flooding extremes driven by strengthened Walker circulation

A recent increase in extreme flooding in Amazonia is linked to intensification of the atmospheric east-west Walker circulation. The Amazon basin is the largest watershed on Earth. Although the variability of the Amazon hydrological cycle has been increasing since the late 1990s, its underlying causes have remained elusive. We use water levels in the Amazon River to quantify changes in extreme events and then analyze their cause. Despite continuing research emphasis on droughts, the largest change over recent decades is a marked increase in very severe floods. Increased flooding is linked to a strengthening of the Walker circulation, resulting from strong tropical Atlantic warming and tropical Pacific cooling. Atlantic warming due to combined anthropogenic and natural factors has contributed to enhance the change in atmospheric circulation. Whether this anomalous increase in flooding will last depends on the evolution of the tropical inter-ocean temperature difference.
Computer self-administered screening for substance use in university student health centers

Abstract Objective: To characterize the prevalence of tobacco, alcohol, and drug use and the acceptability of screening in university health centers. Participants: Five hundred and two consecutively recruited students presenting for primary care visits in February and August, 2015, in two health centers. Methods: Participants completed anonymous substance use questionnaires in the waiting area, and had the option of sharing results with their medical provider. We examined screening rates, prevalence, and predictors of sharing results. Results: Past-year use was 31.5% for tobacco, 67.1% for alcohol (>4 drinks/day), 38.6% for illicit drugs, and 9.2% for prescription drugs (nonmedical use). A minority (43.8%) shared screening results. Sharing was lowest among those with moderate-high risk use of tobacco (OR =0.37, 95% CI 0.20–0.69), alcohol (OR =0.48, 95% CI 0.25–0.90), or illicit drugs (OR =0.38, 95% CI 0.20–0.73). Conclusions: Screening can be integrated into university health services, but students with active substance use may be uncomfortable discussing it with medical providers.
Whole Exome Sequencing Identifies a Novel Hedgehog-Interacting Protein G516R Mutation in Locally Advanced Papillary Thyroid Cancer

Locally advanced thyroid cancer exhibits aggressive clinical features requiring extensive neck dissection. Therefore, it is important to identify changes in the tumor biology before local progression. Here, whole exome sequencing (WES) using tissues from locally advanced papillary thyroid cancer (PTC) presented a large number of single nucleotide variants (SNVs) in the metastatic lymph node (MLN), but not in normal tissues and primary tumors. Among those MLN-specific SNVs, a novel HHIP G516R (G1546A) mutation was also observed. Interestingly, in-depth analysis for exome sequencing data from the primary tumor presented altered nucleotide ‘A’ at a very low frequency indicating intra-tumor heterogeneity between the primary tumor and MLN. Computational prediction models such as PROVEAN and Polyphen suggested that HHIP G516R might affect protein function and stability. In vitro, HHIP G516R increased cell proliferation and promoted cell migration in thyroid cancer cells. HHIP G516R, a missense mutation, could be a representative example for the intra-tumor heterogeneity of locally advanced thyroid cancer, which can be a potential future therapeutic target for this disease.
Positive Tumor Response to Combined Checkpoint Inhibitors in a Patient With Refractory Alveolar Soft Part Sarcoma: A Case Report

A 29-year-old man was initially diagnosed with alveolar soft part sarcoma (ASPS) inMay2011after presenting with acute abdominal pain requiring an exploratory laparotomy for an incarcerated internal jejunal hernia and an inflamed appendix. A 5.4-cm subdiaphragmatic mass was incidentally found during this procedure. The mass was removed. The patient had disease recurrence in May 2012 with distant metastases involving the lung, liver, pericardium, and omentum. The patient underwent surgical extirpation of liver and pericardial lesions. Further progression in lung metastases was noted by September 2012, and the patient underwent a right lung wedge resection. Between December 2012 and June 2015, he received multiple lines of vascular endothelial growth factor receptor (VEGFR)–targetedkinase inhibitors, including sunitinib, pazopanib, and axitinib, but the disease eventually progressed. Stable disease was the best response noted for each of these regimens before progression. Beginning in November 2015, he was treated with two cycles of liposomal doxorubicin with progression of disease.
Multi-scale morphological feature extraction for the classification of micro-calcifications

Mammography is considered the most appropriate method to defeat breast cancer in population screening. Although mammography is used for the detection of micro-calcifications, the benign/malignant classification relies on subsequent histology assessment. We describe a novel method for the automatic classification of benign and malignant micro-calcifications directly from mammographic images, which uses the morphology as well as the distribution aspects of micro-calcifications and is directly associated with the BIRADS categorization of microcalcifications. The developed approach is building on Iwanowski’s morphology work, but is adding class-extractors and multi-scale aspects. Translation to other application areas is discussed and evaluation based on the MIAS and DDSM datasets show results in line with stateof-the-art micro-calcifications classification approaches.
Evaluation of retinal microvascular density in patients affected by systemic lupus erythematosus: an optical coherence tomography angiography study

Retinopathy in systemic lupus erythematosus (SLE) has an incidence of 7%–29% and is suggestive of high disease activity being a marker of poor visual outcome and prognosis for survival.1 Recently, we demonstrated a subclinical retinal involvement in patients with SLE that seems to be related to kidney involvement where hydroxychloroquine had a protective role.2 The pathogenesis of lupus retinopathy is attributed to a vasculopathy most commonly immune complex-mediated microangiopathy.1 Optical coherence tomography angiography (OCTA) is a non-invasive technique for imaging the microvasculature of the retina and choroid that may quantify foveal avascular zone, non-perfused or low-perfused areas. Quantitative measurements based on OCTA may have value in managing retinopathy but also correlate with visual outcome and mirror vascular involvement in systemic diseases.3 The aim of this study was to evaluate retinal microvasculature using OCTA in patients with SLE without signs of retinopathy according to standard lupus retinopathy classification4 and correlate abnormal vascular density with disease activity, damage …
Structural disorder in four-repeat Tau fibrils reveals a new mechanism for barriers to cross-seeding of Tau isoforms

The intracellular deposition of fibrils composed of the microtubule-associated protein Tau is a characteristic feature of Alzheimer's disease (AD) and other fatal neurodegenerative disorders collectively known as tauopathies. Short Tau fibrils spread intracerebrally through transfer between interconnected neurons. Once taken up by a recipient cell, Tau fibrils recruit Tau monomers onto their ends. Based on the number of microtubule-binding repeats, there are two distinct groups of Tau isoforms: three-repeat (3R) Tau and four-repeat (4R) Tau. In AD, all Tau isoforms are deposited, whereas in other tauopathies, only 3R or 4R Tau isoforms are deposited. The molecular basis for these isoform-specific depositions is poorly understood, although conformation-based cross-seeding barriers are key. Here, we used sedimentation assays, EPR spectroscopy, and other structural readouts to better understand the cross-seeding barriers of 4R Tau fibrils. We observed that fibrils formed from truncated Tau (K18), but not full-length Tau (htau40), exhibit a barrier that inhibits 3R Tau recruitment. Investigating an array of differently sized fragments, we found that the Tau C terminus modulates the cross-seeding barrier and that the N terminus plays a synergistic role. Two disease-associated Tau variants, P301S and P301L, also established strong cross-seeding barriers. EPR analysis indicated that fibrils seeded with truncated and mutated Tau, but not htau40, are structurally disordered in the second half of repeat four and onward. These findings suggest that the disorder in this region diminishes the ability of 4R Tau fibrils to recruit 3R Tau monomers, revealing a new mechanism for Tau cross-seeding barriers.
Nursing attitudes towards continuous capnographic monitoring of floor patients

Introduction Nurses’ perceptions of the utility of capnography monitoring are inconsistent in previous studies. We sought to outline the limitations of a uniform education effort in bringing about consistent views of capnography among nurses. Methods A survey was administered to 22 nurses in three subacute care floors participating in a pragmatic clinical trial employing capnography monitoring in a large, urban tertiary care hospital. A 5-point Likert scale was used to assess the value and acceptance nurses ascribed to the practice. Means and SD were calculated for each response. Results Survey results indicated inconsistency in the valuation of capnography, coupled with varying degrees of acceptance of its use. The mean for the level of perceived impact of capnography use on patient safety was 3.86, yet the perceived risk of removing capnography was represented by a mean of 2.57. The levels of urgency attached to apnoea alarms (mean 3.57, SD 1.57) were lower than those for alarms for oxygen saturation violations (mean 3.67, SD 1.32). The necessity for pulse oximetry monitoring was perceived as much higher than that for capnography monitoring (mean 1.76, SD 1.34), where ‘1’ represented pulse oximetry as more necessary and ‘5’ represented capnography as more necessary. Conclusions Nursing acceptance of capnography monitoring is a difficult endpoint to achieve. There is a need for better accounting for the external and internal influences on nurse perceptions and values to have greater success with the implementation of similar monitoring.
Philosophy and Application of High-Resolution Temperature Sensors for Stratified Waters

Every application may have its specifically designed sensor. For studying the effects of short-term temperature variations on life in water, a high-resolution sensor has been designed with low noise level <0.1 mK. Pro and cons of the design include its adequacy for use in large heat-capacity environments like water but less in air. The sensor can be used under high static environmental pressure of >1000 Bar (>108 N m−2) in the deepest ocean regions. Its response time of 0.5 s in water allows quantitative studies of internal wave turbulent mixing effects, e.g., on the redistribution of matter and on nearly completely submerged human bodies. In a chain of >100 sensors, clocks are synchronized to sample within 0.02 s and a verified range of 600 m.
Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases

Hemorrhagic shock is a rare, emergent condition that is often fatal in newborns. In this article, we report cases of 3 neonates presenting with acute, life-threatening hemorrhage who were subsequently diagnosed with severe hemophilia (<1% factor VIII). The first infant was tachycardic, pale, and had a precipitous drop in his hemoglobin secondary to a subgaleal hemorrhage. The second patient sustained a splenic rupture, a sequela that has been reported in only 4 other neonatal cases. The last infant presented with tonic-clonic seizures and respiratory distress. Head imaging demonstrated extracranial and intracranial hemorrhage, complications that can result in 20% mortality. All 3 patients were successfully treated with clotting factor concentrate and blood products. After normalization of factor VIII levels, the newborns did not develop any new hemorrhages and were discharged home within 3 weeks of birth. Pediatric providers should be aware that these signs and symptoms may be potentially lethal complications in neonates with severe factor VIII deficiency.