Miracle-dz/UniFAR-FTUs huggingface dataset:
Return to work after treatment for breast cancer: single-center experience in a cohort of 273 patients.

An increasing number of patients are treated for breast cancer during professional life. A meta-analysis published in February 2009 found that breast cancer survivors were more unemployed than healthy control participants (35.6% versus 31.7%, pooled RR, 1.28; 95% confidence interval: 1.11–1.49) [1]. We report a retrospective study that assesses both medical and socioprofessional factors impacting on the likelihood of patients to return to work after treatment. Between 1 January 2004 and 31 December 2005, a cohort of 1067 patients who were <60 years of age and had been surgically treated in our institution received a questionnaire with medical, sociodemographic and professional items. An answer was obtained in 586 cases. After excluding in situ carcinomas, local relapses, bilateral tumors and patients without professional activity before treatment, 273 patients were assessable. All the clinical files of these patients were reviewed. We studied return to work qualitatively (by univariate and then by multivariate logistic regression) and quantitatively, by measuring time to return to work (by logrank and then by multivariate Cox model). Overall, 79.8% of the patients returned to work after a median delay of 11.5 months. In the multivariate analysis, the factors affecting the return to work were age (P < 0.0001), particularly patients >55 years returning to work in 58% of cases versus more than 80% in younger ones, educational level (P < 0.001), colleague support (P < 0.001), chemotherapy (P < 0.05), lymphedema (P < 0.01), and the physical (P = 0.01) and psychological (P < 0.01) professional constraints of the job. Local pain with ankylosis of the shoulder was significant only in the univariate analysis (P < 0.0001). The factors affecting time to return to work were similar. We showed there was no significant difference observed according to type of surgery, tumorectomy versus mastectomy, sentinel lymph node versus axillary clearance, radiation therapy or not, and hormonotherapy or not. It is important to interpret this study in the context of the French social model. Our return to work rate is similar to that of previous publications [2, 3], whereas the length of sick leave is much longer as compared with English and North American studies [4]. As in previous publications, age is one of the main factors correlated with a lower rate of return to work [2, 3, 5]. The only clinical factor negatively correlated with the return to work is chemotherapy. This treatment also delays the return to work: 14.3 versus 7.2 months for patients who did not receive letters to the editor Annals of Oncology
Evaluation of Knee Stability Before and After Participation in a Functional Sports Agility Program During Rehabilitation After Anterior Cruciate Ligament Reconstruction

We sought to determine whether participation in a functional sports agility program as early as 4 weeks after anterior cruciate ligament reconstruction with autogenous patellar tendon graft would affect objective knee stability in 603 patients. The rehabilitation program prescribed a functional sports agility program at a mean of 5.1 1.0 weeks postoperatively when full knee hyperextension, knee flexion to 120°, and quadriceps muscle strength of 60% of the normal leg had been achieved. The patients had KT-1000 arthrometer testing before beginning the program and at subsequent follow-up after they had performed the sport activity. The mean manual maximum KT-1000 arthrometer difference was 1.9 1.3 mm at initial testing and 1.9 1.2 mm at follow-up testing. The frequency distribution of the KT-1000 arthrometer scores revealed that 92.7% of patients at initial testing and 93.2% of patients at follow-up testing had displacement difference of 3 mm or less. The results of this study show that functional sports agility programs during the early rehabilitation period after anterior cruciate ligament reconstruction with a correctly placed autogenous patellar tendon graft do not cause a change in graft stability.
The relationship between indicators of sexual compulsivity and high risk sexual practices among men and women receiving services from a sexually transmitted infection clinic

Sexual compulsivity, defined by sexual preoccupation and lack of sexual impulse control, is related to high‐risk sexual behaviors. However, little is known about the prevalence and predictors of sexual compulsivity in people at high risk for contracting sexually transmitted infections (STIs). In the current study, patients receiving diagnostic and treatment services (85% African American) at an urban STI clinic completed measures of demographic characteristics, sexual compulsivity, substance use, and sexual behaviors. Measures were administered to 492 men and 193 women using confidential procedures and audio computer‐assisted interviewing technology. Results showed that men and women receiving STI clinic services frequently endorsed multiple indicators of sexual compulsivity. In this mostly African American sample, individuals with scores above the 80th percentile on the sexual compulsivity scale (translating to over one standard deviation above the mean) had more sex partners, engaged in higher rates of sexual risk behaviors with casual or one‐time sex partners, and were nearly four times as likely to have been recently diagnosed with multiple STIs than were individuals who scored below the 80th percentile. Although sexual compulsivity scores were associated with alcohol and other drug use, associations between sexual compulsivity and sexual risks were not accounted for by substance abuse. Findings suggest an urgent need for interventions to help men and women with sexual preoccupations and poor sexual impulse control to reduce their risks for sexually transmitted infections.
Distribution of Helicobacter pylori cagA, cagE and vacA in different ethnic groups in Kuala Lumpur, Malaysia

Background and Aims: There is a geographic variation in Helicobacter pylori (HP) genotypes and virulence factors. Cytotoxin associated genes A (cagA) and E (cagE), and certain vacuolating cytotoxin (vacA) genotypes are associated with peptic ulcer disease (PUD). There is also a different prevalence of PUD among different ethnic groups in Malaysia. The present study compared the distribution of vacA alleles and cagA and cagE status in three ethnic groups residing in Kuala Lumpur, Malaysia, and their association with clinical outcome.
Sonographic brightness of the flexor tendons and ligaments in the metacarpal region of horses.

Sonographic observations were made of the image mean gray scale (MGS) of the flexor tendons and ligaments in the left and right metacarpal regions of each of 10 clinically normal horses. In images made in the dorsal and sagittal planes, the MGS was measured at multiple sites in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament (AL), and suspensory ligament (SL), and at single sites in the medial and lateral limbs of the SL, and the palmar ligament. Relative sonographic brightness of each tendon and ligament was calculated by dividing the value of its MGS by the mean value for the MGS of images of 3 soft tissue equivalent phantoms. When a multivariate repeated-measures of ANOVA of the relative brightness values was statistically significant (P < or = 0.05), Tukey's method of multiple comparisons was used to determine which values were significantly different from each other. In the dorsal plane, the SL was significantly brighter than the DDFT, SDFT, and AL; relative brightness of the DDFT and SDFT were similar, as were those of the SDFT and AL. In the sagittal plane, the SL again was the significantly brightest structure, followed by the AL, and similar brightness of the DDFT and SDFT. In dorsal images made 25 cm distal to the accessory carpal bone, relative brightness of the SDFT, DDFT, and the medial and lateral limbs of the SL were similar. (ABSTRACT TRUNCATED AT 250 WORDS)
Investigating student perceptions at an interprofessional student-run free clinic serving marginalised populations

ABSTRACT Many health profession schools have student-run free clinics (SRFCs), but their educational relevance has not been well studied. The aim of this study was to evaluate the learning experiences and skills developed among interprofessional healthcare students at an SRFC serving marginalised populations, in order to provide data for ongoing programme improvement and recommendations for other SRFCs based on lessons learned. Under 1:1 supervision with a preceptor, interprofessional students completed three clinical shifts at an SRFC and attended a reflection session. A total of 101 out of 105 participants answered semi-structured pre- and post-programme surveys (response rate: 96%). Descriptive statistics and descriptive thematic analyses were used for quantitative and qualitative data, respectively. Numerous skills derived from learning objectives common to many healthcare professions were addressed while participating at the SRFC. Valued programme elements included working with and learning about inner city populations in an interprofessional care model. Interprofessional SRFCs encourage student learning about resources for inner city populations and interprofessional collaboration while providing an opportunity to develop skills related to the formal curriculum. This may provide a workable strategy to address an interprofessional education gap in the healthcare professional curriculum.
Red blood cell distribution width: a strong prognostic marker in cardiovascular disease: is associated with cholesterol content of erythrocyte membrane.

OBJECTIVES Red blood cell distribution width (RDW), a measure of the variability in size of circulating erythrocytes, has recently been shown to be a strong predictor of adverse outcomes in patients with a great spectrum of cardiovascular disease. Recently, cholesterol content of erythrocytes membranes (CEM) has been associated with clinical instability in coronary artery disease whilst it has been linked with red blood cells (RBC) size and shape. Since the biological mechanisms underlying the association of higher RDW with cardiovascular mortality risk are currently unclear, we studied the association of CEM with RDW. METHODS 296 consecutive angina patients (236 men, mean age 69 ± 2 years) were prospectively assessed; 160 had chronic stable angina (CSA) and 136 had an acute coronary syndrome (ACS). RESULTS Patients presenting with ACS had increased CEM levels (121.6 μg/mg (40.1) vs 74.4 μg/mg (26.6), p < 0.001) as well as exhibited greater anisocytosis (13.9% (0.9) vs 13.3% (0.7), p < 0.001) compared to patients with CSA. Simple correlation analysis showed that CEM levels were positively associated with RDW values (r = 0.320, p < 0.001). Multivariable linear regression showed that CEM levels were associated with RDW values independently from possible confounders (inflammatory, nutritional renal or hematological). CONCLUSIONS Data from the present study showed an independent association between cholesterol content of erythrocyte membranes and anisocytosis. Increased CEM levels -a novel biomarker of clinical instability in CAD - may facilitate our understanding why RDW is associated with increased morbidity and mortality in cardiovascular disease.
Folding of intracellular retinol and retinoic acid binding proteins

The folding mechanisms of cellular retinol binding protein II (CRBP II), cellular retinoic acid binding protein I (CRABP I), and cellular retinoic acid binding protein II (CRABP II) were examined. These β‐sheet proteins have very similar structures and higher sequence homologies than most proteins in this diverse family. They have similar stabilities and show completely reversible folding at equilibrium with urea as a denaturant. The unfolding kinetics of these proteins were monitored during folding and unfolding by circular dichroism (CD) and fluorescence. During unfolding, CRABP II showed no intermediates, CRABP I had an intermediate with nativelike secondary structure, and CRBP II had an intermediate that lacked secondary structure. The refolding kinetics of these proteins were more similar. Each protein showed a burst‐phase change in intensity by both CD and fluorescence, followed by a single observed phase by both CD and fluorescence and one or two additional refolding phases by fluorescence. The fluorescence spectral properties of the intermediate states were similar and suggested a gradual increase in the amount of native tertiary structure present for each step in a sequential path. However, the rates of folding differed by as much as 3 orders of magnitude and were slower than those expected from the contact order and topology of these proteins. As such, proteins with the same final structure may not follow the same route to the native state. Proteins 2001;43:292–302. © 2001 Wiley‐Liss, Inc.
Influence of Seed Head–Attacking Biological Control Agents on Spotted Knapweed Reproductive Potential in Western Montana Over a 30-Year Period

Abstract Five insect biological control agents that attack flower heads of spotted knapweed, Centaurea stoebe L. subsp. micranthos (Gugler) Hayek, became established in western Montana between 1973 and 1992. In a controlled field experiment in 2006, seed-head insects reduced spotted knapweed seed production per seed head by 84.4%. The seed production at two sites in western Montana where these biological control agents were well established was 91.6–93.8% lower in 2004–2005 than 1974–1975, whereas the number of seed heads per square meter was 70.7% lower, and the reproductive potential (seeds/m2) was 95.9–99.0% lower. The average seed bank in 2005 at four sites containing robust spotted knapweed populations was 281 seeds/m2 compared with 19 seeds/m2 at four sites where knapweed density has declined. Seed bank densities were much higher at sites in central Montana (4,218 seeds/m2), where the insects have been established for a shorter period. Urophora affinis Frauenfeld was the most abundant species at eight study sites, infesting 66.7% of the seed heads, followed by a 47.3% infestation by Larinus minutus Gyllenhal and L. obtusus Gyllenhal. From 1974 to 1985, Urophora spp. apparently reduced the number of seeds per seed head by 34.5–46.9%; the addition of Larinus spp. further reduced seed numbers 84.2–90.5% by 2005. Path analysis indicated that both Larinus spp. and U. affinis contributed significantly to reduction of seed production over the 30-yr period. Spotted knapweed density may not decrease significantly until the seed bank falls below a critical threshold.
Clinical outcome in diffuse large B-cell lymphoma is dependent on the relationship between different cell-cycle regulator proteins.

PURPOSE The goal of this work was to perform a comprehensive exploration of the relationship between the clinical outcome of diffuse large B-cell lymphoma (DLBCL) and the expression of a panel of tumor suppressor and oncogenic proteins, which includes some cell-cycle regulator proteins involved in the p53 pathway. PATIENTS AND METHODS To this end, we collected the clinical data of 141 patients with DLBCL and immunohistochemically analyzed diagnostic tumoral tissue from each patient for the presence of Ki67 (MIB1, Immuno-tech, Marseille, France), bcl2, p53, p21/WAF1, MDM2, and retinoblastoma (Rb) proteins. RESULTS The results show that several proteins are associated with some of the clinical traits analyzed. Multivariate analysis showed that an extended overall survival (OS) time was associated with low growth fraction, high Rb protein, and low MDM2 expression, as well as with known clinical parameters. The probability of inducing a complete remission (CR) was only associated with clinical parameters, although univariate study showed that a low growth fraction was associated with a higher probability of inducing a CR. Univariate study of disease-free survival (DFS) showed that tumors with high bcl2 expression and nodal origin have a shorter DFS time, although multivariate study only confirmed the adverse effect of bcl2 expression. CONCLUSION Taking all these results into consideration, it seems that although the overall outcome for patients with DLBCL is decided by a combination of different clinical and biologic variables, the expression of some of these cell-cycle regulator proteins appears to be specifically associated with the different clinical features of tumors.
Wilson's disease in Israel: a genetic and epidemiological study

Clinical and family history data on persons affected with Wilson disease (WD) living in Israel between 1958 and 1984 were ascertained from the literature, hospital records and neurological and gastroenterological clinics. From this population of 51 families, representing a diversity of Middle Eastern, North African and European backgrounds, blood samples were collected from affected individuals in 21 families, their parents, sibs and other relatives for quantitative determinations of plasma copper and ceruloplasmin, liver tests and DNA analysis. Although the majority of patients have the hepatic form of the disease, hepatic and neurological cases were found among all ethnic groups. In fact, affected sibs in several inbred families who most likely inherited two copies of the same mutant allele had different symptoms. Gene frequencies were calculated for each of the populations taking into account inbreeding, probability of ascertainment, and estimated incidence. Although many of these communities have gene frequencies which are comparable to worldwide estimates, high prevalence of disease is maintained by consanguineous mating patterns. Probabilities of WND genotypes were calculated for 129 unaffected relatives who had an a priori risk of inheriting at least one WND allele using information from 10 DNA markers closely linked to the WND locus. There was no evidence that multiple loci are responsible for the observed clinical variability in this sample of families. Furthermore, studies of serum copper and ceruloplasmin levels in unaffected relatives suggest that phenotypic variability in WD may be due in part to an interaction of the WND locus with other genetic or non‐genetic modifiers such as age.
Evaluation of Carbapenemase Screening and Confirmation Tests with Enterobacteriaceae and Development of a Practical Diagnostic Algorithm

ABSTRACT Reliable identification of carbapenemase-producing members of the family Enterobacteriaceae is necessary to limit their spread. This study aimed to develop a diagnostic flow chart using phenotypic screening and confirmation tests that is suitable for implementation in different types of clinical laboratories. A total of 334 clinical Enterobacteriaceae isolates genetically characterized with respect to carbapenemase, extended-spectrum β-lactamase (ESBL), and AmpC genes were analyzed. A total of 142/334 isolates (42.2%) were suspected of carbapenemase production, i.e., intermediate or resistant to ertapenem (ETP) and/or meropenem (MEM) and/or imipenem (IPM) according to EUCAST clinical breakpoints (CBPs). A group of 193/334 isolates (57.8%) showing susceptibility to ETP, MEM, and IPM was considered the negative-control group in this study. CLSI and EUCAST carbapenem CBPs and the new EUCAST MEM screening cutoff were evaluated as screening parameters. ETP, MEM, and IPM with or without aminophenylboronic acid (APBA) or EDTA combined-disk tests (CDTs) and the Carba NP-II test were evaluated as confirmation assays. EUCAST temocillin cutoffs were evaluated for OXA-48 detection. The EUCAST MEM screening cutoff (<25 mm) showed a sensitivity of 100%. The ETP APBA CDT on Mueller-Hinton agar containing cloxacillin (MH-CLX) displayed 100% sensitivity and specificity for class A carbapenemase confirmation. ETP and MEM EDTA CDTs showed 100% sensitivity and specificity for class B carbapenemases. Temocillin zone diameters/MIC testing on MH-CLX was highly specific for OXA-48 producers. The overall sensitivity, specificity, positive predictive value, and negative predictive value of the Carba NP-II test were 78.9, 100, 100, and 98.7%, respectively. Combining the EUCAST MEM carbapenemase screening cutoff (<25 mm), ETP (or MEM), APBA, and EDTA CDTs, and temocillin disk diffusion on MH-CLX promises excellent performance for carbapenemase detection.
Altered Functional Connectivity Following an Inflammatory White Matter Injury in the Newborn Rat: A High Spatial and Temporal Resolution Intrinsic Optical Imaging Study

Very preterm newborns have an increased risk of developing an inflammatory cerebral white matter injury that may lead to severe neuro-cognitive impairment. In this study we performed functional connectivity (fc) analysis using resting-state optical imaging of intrinsic signals (rs-OIS) to assess the impact of inflammation on resting-state networks (RSN) in a pre-clinical model of perinatal inflammatory brain injury. Lipopolysaccharide (LPS) or saline injections were administered in postnatal day (P3) rat pups and optical imaging of intrinsic signals were obtained 3 weeks later. (rs-OIS) fc seed-based analysis including spatial extent were performed. A support vector machine (SVM) was then used to classify rat pups in two categories using fc measures and an artificial neural network (ANN) was implemented to predict lesion size from those same fc measures. A significant decrease in the spatial extent of fc statistical maps was observed in the injured group, across contrasts and seeds (*p = 0.0452 for HbO2 and **p = 0.0036 for HbR). Both machine learning techniques were applied successfully, yielding 92% accuracy in group classification and a significant correlation r = 0.9431 in fractional lesion volume prediction (**p = 0.0020). Our results suggest that fc is altered in the injured newborn brain, showing the long-standing effect of inflammation.
Retrospective study of 229 surgically treated patients with brain metastases: Prognostic factors, outcome and comparison of recursive partitioning analysis and diagnosis-specific graded prognostic assessment

Background: Metastases are the most frequent tumors in the brain. Most often used scoring systems to predict the outcome are the RPA (Recursive Partitioning Analysis) classification and the DS-GPA (Diagnosis-Specific Graded Prognostic Assessment) score. The goal of our study was to determine prognostic factors which influence outcome in patients who undergo surgery for brain metastases and to compare different outcome scores. Methods: Two hundred and twenty-nine patients who underwent surgery for brain metastases in our institution between January 2005 and December 2014 were included in the study. Patient data were evaluated retrospectively. Results: The mean survival time was 19.2 months (median survival time, MST: 8 months), for patients with a single metastasis (n = 149) 17.6 months (MST: 8 months), and for patients with multiple metastases (n = 80) 17.9 months (MST: 6 months). Significant influence on MST had age <65 years (9 vs. 5 months, P = 0.002), female sex (10 vs. 6 months, P < 0.001), RPA Class I and II (11 vs. 4 months, P < 0.001), Karnofsky score >70% (11 vs. 4 months, P < 0.001), and postoperative radiotherapy (8 vs. 5 months, P < 0.002). To evaluate the diagnostic power of DS-GPA and RPA score in respect of survival, two Cox regressions were modeled, where the RPA classification showed a better predictive power. Conclusion: Favorable factors for prolonged survival were KPS >70%, RPA Class I and II, age <65 years, female sex, a DS-GPA Score of 2.5–3 and 3.5–4, and adjuvant radiotherapy. The RPA Classification was more accurate in predicting the outcome than the DS-GPA score.