Miracle-dz/UniFAR-FTUs huggingface dataset:
A simple, robust, validated and highly predictive index for the determination of risk‐directed therapy in acute myeloid leukaemia derived from the MRC AML 10 trial

Data on 1711 patients, aged up to 55 years, in the MRC AML 10 trial were used to create a prognostic index for use in risk‐directed therapy decision making for younger patients with acute myeloid leukaemia (AML). Two parameters, response after course 1 and cytogenetics, were strongly predictive of outcome. For patients with complete remission, partial remission and resistant disease, 5‐year survival from the start of course 2 was 53%, 44% and 22% and relapse rates were 46%, 48% and 69% respectively, and for patients with favourable, intermediate and adverse karyotypic abnormalities, survival was 72%, 43% and 17% and relapse rates were 34%, 51% and 75% respectively (all P < 0.0001). Patients with FAB type M3 but no cytogenetic t(15;17) also had a low relapse rate (29%). These three factors were combined to give three risk groups: good (favourable karyotype or M3, irrespective of response status or presence of additional abnormalities), standard (neither good nor poor), poor (adverse karyotype or resistant disease, and no good‐risk features). Survival for these three groups was 70%, 48% and 15% respectively and relapse rates were 33%. 50% and 78% (both P < 0.0001). The index is simple (based on just three parameters), robust (derived from 1711 patients), highly discriminatory (55% survival difference between good and poor risk) and validated, so can be applied in the clinical setting to assist with therapeutic decisions as in the current AML 12 trial.
Endoscopic Treatment of Gastric Adenoma with Argon Plasma Coagulation

The term gastric adenoma means a benign lesion of the glandular epithelium having variable degrees of cellular atypia and showing papillary or tubular structures. Because long-term follow-up studies of gastric adenomas reveal malignant transformations, it is well known they are premalignant. Since these lesions lie histologically and clinically on the borderline of between whether they are benign or malignant, it is extremely important for clinicians to determine whether they are to be treated or not (Morson, 1980; Kamiya, 1982; Rugge, 1994). For a long time, there was no specific treatment policy of gastric adenomas and treatment varied from close endoscopic follow-ups to endoscopic resection, considering its heterogeneous clinical consequences (Di Gregorio, 1993; Saraga, 1987). When gastric epithelial dysplasia is classified using the two or three tier system, each group shows a different clinical course. For gastric adenoma with high grade dysplasia (HGD), endoscopic resection has become the standard treatment because of risk of malignant progression and synchronous carcinomas (Lansdown, 1990; Farinati, 1993). Many western publications have recommended close endoscopic follow-up of patients with moderate/low grade gastric epithelial dysplasia (Rugge, 1991, Fertitta, 1993; Rugge, 1991). The frequency of the followup has been recommended to be every three to 12 months at least during the first year, but it is still unknown of how long the follow-up should be maintained for when no progression has been detected (Bearzi, 1994; Fertitta, 1993). The disadvantages of endoscopic follow-ups are patient anxiety, risk of disease progression, and low patient compliance for an undefined period (Lansdown, 1990; Rugge, 1991). Though endoscopic resection has become frequently applied for gastric adenoma with low grade dysplasia (LGD), there is ongoing controversy considering its relatively benign natural course and clinical significance. Although endoscopic resection is a less invasive procedure than surgical resection, it still carries the risk of complications and requires hospitalization of several days (Ono 2001, O'Mahony, 2001; Miyata 2000). Argon plasma coagulation (APC) is a kind of non-contact technique for tissue coagulation, which transfers high-frequency electric current through ionized argon gas to targeted lesions (Grund, 1994; Grunde, 1997). Because APC has an advantage of confining the thermal effect to the superficial layer of the gastrointestinal wall, APC has been used for the treatment of bleeding ulcers, hemorrhagic telangiectasias, and tumors (Chau, 2003;
Subclinical myocardial impairment in SLE: insights from novel ultrasound techniques and clinical determinants.

AIMS Myocardial damage is frequent and often silent in systemic lupus erythematosus (SLE). The aim of the study was to determine the prevalence of myocardial damage by novel ultrasound techniques and to systematically assess the relationship between subclinical cardiac dysfunction and SLE-related clinical parameters. MATERIAL AND METHODS Seventy-five consecutive SLE patients without evidence of cardiac disease and seventy-three controls underwent standard transthoracic echocardiography using classical and novel ultrasound techniques: tissue Doppler imaging and speckle tracking echocardiography. Patient characteristics, cumulative organ damage and laboratory data were retrieved by medical chart review. RESULTS Within the cohort, 89.3% of the patients were female; mean+/-SD age and median (IQR) disease duration were 43.2+/-12.5 years and 8.03(6.3) years, respectively. SLE patients exhibited a significant decrement in endocardial longitudinal strain (-18.4% vs 19.3%, p=0.001) compared with controls. Diastolic dysfunction was detected in 34 (45.3%) of SLE patients. Major determinants of systolic and diastolic dysfunction were hypertension (p=0.023 and p<0.001, respectively), associated antiphospholipid syndrome (APS) (p<0.001 and p<0.001, respectively), cumulative damage accrual (p<0.001 and p=0.003, respectively), and disease duration (p=0.03 and p<0.001, respectively). Notably, anti-Ro antibodies were present in 37% of the SLE patients who had better systolic longitudinal performance. Neither disease activity, nor specific organ involvement, were associated with myocardial impairment. CONCLUSION Systolic longitudinal and diastolic performance impairments are frequent findings in SLE patients without overt cardiovascular disease. Cumulative organ damage, disease duration, APS, and hypertension are major determinants for early heart involvement in SLE patients.
Neuronal P2X7 Receptors Revisited: Do They Really Exist?

P2X7 receptors (Rs) constitute a subclass of ATP-sensitive ionotropic receptors (P2X1-P2X7). P2X7Rs have many distinguishing features, mostly based on their long intracellular C terminus regulating trafficking to the cell membrane, protein–protein interactions, and post-translational modification. Their C-terminal tail is especially important in enabling the transition from the nonselective ion channel mode to a membrane pore allowing the passage of large molecules. There is an ongoing dispute on the existence of neuronal P2X7Rs with consequences for our knowledge on their involvement in neuroinflammation, aggravating stroke, temporal lobe epilepsy, neuropathic pain, and various neurodegenerative diseases. Whereas early results appeared to support the operation of P2X7Rs at neurons, more recently glial P2X7Rs are increasingly considered as indirect causes of neuronal effects. Specific tools for P2X7Rs are of limited value because of the poor selectivity of agonists, and the inherent failure of antibodies to differentiate between the large number of active and inactive splice variants, or gain-of-function and loss-of-function small nucleotide polymorphisms of the receptor. Unfortunately, the available P2RX7 knock-out mice generated by pharmaceutical companies possess certain splice variants, which evade inactivation. In view of the recently discovered bidirectional dialogue between astrocytes and neurons (and even microglia and neurons), we offer an alternative explanation for previous data, which assumedly support the existence of P2X7Rs at neurons. We think that the unbiased reader will follow our argumentation on astrocytic or microglial P2X7Rs being the primary targets of pathologically high extracellular ATP concentrations, although a neuronal localization of these receptors cannot be fully excluded either.
A STUDY OF HEAT STRESS EXPOSURES AND INTERVENTIONS FOR MINE RESCUE WORKERS

Researchers from the National Institute for Occupational Safety and Health (NIOSH), in cooperation with mine operators, conducted a study of heat stress exposures among mine rescue workers in underground mines. Mine rescue workers face extreme heat loads as they enter hot and poorly ventilated environments, particularly when they are wearing breathing apparatuses. The burden of wearing a closed-circuit breathing apparatus (CCBA), the inability to drink fluids for extended periods of time, and the potential for ventilation disruptions and fires combine to increase the risk of heat illness during a response to an emergency. In this research, ambient environmental conditions and heat strain indicators were measured using conventional ventilation monitoring tools during mine rescue training exercises. Heat strain was measured with an ingestible temperature-sensing pill that measured core temperature continuously. In addition, a heart-rate monitoring chest strap was used to indicate physical strain resulting from physical activity and heat. Both core temperature and heart rate data were trans-mitted to a remote recorder worn by a rescuer and time-stamped. Team activities were also observed to determine the contribution of work rate to a person’s total heat load. The effectiveness of several engineering controls, such as cooling the air inhaled by rescuers through an apparatus, wearing cooling vests, and supplying water through the CCBA masks, were investigated. Administrative controls, such as limiting the duration of exposure and controlling the work rate through forced-rest regimens, were also evaluated. Results to date are discussed, and tools for evaluating team condition and estimating the length of time it would be safe for rescuers to work are proposed.
Regulation of the prevalence and intensity of schistosomiasis in man: immunology or ecology?

The belief that immunity (resistance to reinfection) is a major factor controlling the prevalence and intensity of schistosomiasis in man is a deepseated one. It seems impossible to most observers that subjects in endemic areas who are exposed to infested waters are not constantly reinfected. Furthermore, there is a continuous trickle of anecdotal evidence for the infectivity of the parasite supplied by case reports of individuals from nonendemic areas who became infected (in some cases, heavily) after only short-term exposures. Even though the worms do not multiply in the human body, their ability to live for 20-30 years would suggest that worm burdens should steadily increase to a level resulting in severe morbidity and mortality. Nevertheless, in most endemic areas of the world we can detect relatively little disease and death due to schistosomal infection. Furthermore, when we examine the prevalence and the intensity of infection in relation to age, we usually see a curve which reaches its peak in the teens and declines with advancing years. The occurrence of immunity to schistosomiasis in man is not an obvious phenomenon. As Smithers has stated, "there is no sudden immunologic crisis leading to parasite elimination and a subsequent and sudden development of strong immunity. Instead, immunity appears to develop gradually, taking several years to become pronounced; in the early stages of infection, immunity may be only partial, but nevertheless of vital importance in limiting the infection" [2]. Attempts to study human resistance to reinfection have been exceed-
Micro-indirect hemagglutination test for detection of antibodies to the Ibc protein of group B Streptococcus

A micro-indirect hemagglutination test was developed for detecting antibody against the Ibc protein of group B Streptococcus. Formalin-preserved, tanned sheep erythrocytes were sensitized with a partially purified preparation of Ibc protein from a type Ic strain of group B streptococci. A total of 76% of 103 sera from pregnant and nonpregnant women had demonstrable antibody against this protein, with titers ranging from 10 to 320. Examination of five pairs of mother and cord sera revealed passive transfer of these antibiodies from mother to infant. This testing on a limited number of sera also revealed that elevated antibody titers against Ibc protein were more common among carriers of group B streptococci, especially those harboring strains with Ibc protein antigen, than among noncarriers. The technique described was found to be simple, specific, sensitive, and reproducible and may be of value in assessing the immune status of pregnant women as well as for epidemiological purposes.
Knowledge, attitude and practice regarding folic acid deficiency; A hidden hunger

Objectives: To find the Knowledge Attitude and Practice regarding Folic Acid Deficiency among Women of Child Bearing Age (WPCBA). To find out the Association of Education Level with Practice of Folic Acid in WPCBA. Methods: A Descriptive cross sectional study (Knowledge Practice and Attitude) was conducted at Military Hospital and Combined Hospital Rawalpindi from September 2012 to February 2013. About 400 married females of age group 21-42 years were included by convenient sampling technique. After taking informed verbal consent, a closed ended interviewer administered questionnaire was filled. Data was entered and analyzed using SPSS version 20. Results: Mean age of the respondents was 30.31 + 5.280 years. Illiterate and literate were 165 (41.25%) and 235 (58.75%) respectively. The knowledge regarding folic acid need was 172 (43%). Only 161 (40.25%) thought that folic acid deficiency in pregnant women results in abnormality in newborn. In pregnancy, 205 (51.25%) had received folic acid supplementation. Association between education level and practice of folic acid was significant (p= 0.009) at 95% confidence level. Conclusion: Knowledge regarding folic acid deficiency among WOCBA was low along with the poor attitude. Practice was also not satisfactory. Education status plays important role in preventing micronutrient deficiency.
Urethral pressure reflectometry. A method for simultaneous measurements of pressure and cross-sectional area in the female urethra.

A novel technique for simultaneous measurements of pressure and cross-sectional area (CA) in the female urethra, denoted Urethral Pressure Reflectometry (UPR), was devised. A very thin and highly flexible polyurethane-bag was placed in the urethra. A pump applied increasing and decreasing pressures to the polyurethane-bag and thereby opened and closed the urethra. Sound waves were continually sent into the polyurethane-bag and the cross-sectional area (CA) of the bag (urethra) could be measured from the reflections with Acoustic Reflectometry. The CA of the bag was measured for each mm of the bag and 10 times per second. The examinations were performed with the women supine relaxing, supine squeezing, and standing relaxing. The examination provided measures of the opening pressure (the pressure exactly needed to open the urethra), the closing pressure (the pressure where the urethra closes again after dilation), the opening elastance (the resistance against dilation), the closing elastance (urethras ability to close again after dilation) and the hysteresis (the energy which dissipates when urethra is dilated). The examination was reliable both in vitro and in vivo. All the UPR parameters except the hysteresis were decreased in stress urinary incontinent (SUI) women compared to continent women. Thus the parameters seem to be relevant regarding SUI. UPR examination was performed before and after urethral bulking and from these examinations a mechanism of action of the bulking procedure was proposed. A randomised, double-blinded placebo-controlled cross-over study demonstrated that UPR is valuable in developing and monitoring pharmacological treatments for SUI. Cases demonstrated that UPR has potential to sub-classify SUI in accordance to the patophysiology and establish pathological conditions i.e. a stricture.
Trees tolerate an extreme heatwave via sustained transpirational cooling and increased leaf thermal tolerance

Heatwaves are likely to increase in frequency and intensity with climate change, which may impair tree function and forest C uptake. However, we have little information regarding the impact of extreme heatwaves on the physiological performance of large trees in the field. Here, we grew Eucalyptus parramattensis trees for 1 year with experimental warming (+3°C) in a field setting, until they were greater than 6 m tall. We withheld irrigation for 1 month to dry the surface soils and then implemented an extreme heatwave treatment of 4 consecutive days with air temperatures exceeding 43°C, while monitoring whole‐canopy exchange of CO2 and H2O, leaf temperatures, leaf thermal tolerance, and leaf and branch hydraulic status. The heatwave reduced midday canopy photosynthesis to near zero but transpiration persisted, maintaining canopy cooling. A standard photosynthetic model was unable to capture the observed decoupling between photosynthesis and transpiration at high temperatures, suggesting that climate models may underestimate a moderating feedback of vegetation on heatwave intensity. The heatwave also triggered a rapid increase in leaf thermal tolerance, such that leaf temperatures observed during the heatwave were maintained within the thermal limits of leaf function. All responses were equivalent for trees with a prior history of ambient and warmed (+3°C) temperatures, indicating that climate warming conferred no added tolerance of heatwaves expected in the future. This coordinated physiological response utilizing latent cooling and adjustment of thermal thresholds has implications for tree tolerance of future climate extremes as well as model predictions of future heatwave intensity at landscape and global scales.
Motivation and Attitude of Students towards Learning English Language

Motivation and positive attitude have been widely viewed researchers as key factors that influence in the success of learning English language. This study aimed to determine the level of motivation and attitude towards learning English language. Thus, this study also sought to determine the relationship between respondents’ profile variates and their level of motivation and attitude. Notable results revealed that the respondents’ level of motivation was moderately high and respondents have a positive attitude towards learning English
Prevalence and types of dental anomaly in a Thai non-syndromic oral cleft sample.

OBJECTIVE To investigate the prevalence and characteristics of dental anomalies (DAs); missing teeth (MT), dens-evaginatus (D-E), dens-invaginatus, dilaceration,fusion, gemination, macrodontia, microdontia (Micro), supernumerary teeth (SNT), and taurodontism, in permanent teeth among subjects with non-syndromic oral cleft. MATERIAL AND METHOD This cross-sectional study was designed to assess DAs from diagnostic records; comprising panoramic radiograph, intraoral photographs, dental casts, and orthodontic clinic charts of 280 Northeastern Thai subjects, mean age 10.3 +/- 3.2 years. Chi-square test was used to compare DA prevalences among cleft phenotypes and genders. RESULTS There were one or more teeth with DAs in 89.6% of the study population. Highest prevalence was MT (60.4%) followed by Micro (41.4%), dilaceration (6.4%), SNT (6.1%) , and 0.4% in D-E, fusion, gemination, and taurodontism. The most prevalent MT was found in 70.7% of subjects in bilateral cleft lip and palate group. CONCLUSION The two predominant DAs were MT and Micro, higher prevalences being found with the more severe cleft conditions. The most affected teeth were cleft-site lateral incisors. There were no differences in distribution of DA in male and female.
The “Third” Dimension in Craniofacial Surgery

A new method for reconstruction of a three-dimensional surface from a sequence of high-resolution axial CT scans has been developed. This algorithm is realized as a set of computer programs that can operate on commercially available CT scanners or evaluation consoles. The program is both efficient and easy to implement. No operator intervention is required. The images produced simulate photographs of the skull. Frontal, lateral, oblique, bird's eye, worm's eye, and rear views are generated. As with photographs and conventional radiographs, each of these projections uniquely displays specific anatomic details. This method of osseous surface reconstruction is now routinely applied to all patients evaluated for major craniofacial reconstruction at our institution. The images are useful in defining aberrant anatomy, planning surgical procedures, and evaluating the results of such operations. This method replaces an inexact concept in the surgeon's imagination with a three-dimensional image of the craniofacial skeleton.
Diabetic ketoacidosis, hyperosmolarity and hypernatremia: are high‐carbohydrate drinks worsening initial presentation?

Abstract: The case of five pediatric patients who presented to the Royal Children's Hospital, Melbourne with newly diagnosed diabetes mellitus between January 2001 and September 2003 is reported. Each case was complicated by hyperosmolarity and hypernatremia and required intensive therapy. Fluid intake prior to admission in each case was documented and consisted of between 5 and 12 L of carbonated carbohydrate beverages and ‘isotonic’ sports drinks. At presentation, biochemical results of the four cases (four males and one female), mean age 13.6 yr (range 11.7–15.1 yr) included glucose (mean 1460 mg/dL; range 864–2106), adjusted sodium (mean 176.3 mmol/L; range 165–183), serum osmolarity (mean 399 mmol/kg; range 364–424), anion gap (mean 48 mEq/L; range 42–84), and pH (mean 7.15; range 7.01–7.27). All five cases had evidence of ketonuria on presentation. Treatment in all five cases consisted of replacement of fluids over a prolonged period of 72 h and careful monitoring of electrolyte response. Three of five cases required hemofiltration in the first 48 h postadmission. All five cases made a complete recovery without neurological sequelae. Carbonated carbohydrate fluid intake may precipitate a more severe presentation of type 1 diabetes mellitus (T1DM). Fluid composition and intake should be carefully estimated at admission to help identify and manage similar cases.
Surgical predictors of para-aortic metastases in early-stage cervical carcinoma.

Radical pelvic surgery for cervical carcinoma is contraindicated in the presence of para-aortic node metastases. However, the incidence of para-aortic nodal involvement is very low in early-stage disease. Therefore, it may not be necessary to subject all patients to para-aortic lymphadenectomy prior to radical hysterectomy. Medical records for 408 patients with early-stage cervical carcinoma treated at the Pennsylvania State University-M.S. Hershey Medical Center were reviewed to ascertain if clinical factors can be utilized intraoperatively to accurately predict those patients at minimal risk for para-aortic lymph node metastases. The presence of clinically suspicious (abnormally enlarged or firm) pelvic or para-aortic lymph nodes or extracervical spread of tumor at the time of exploration were significant predictors of para-aortic metastases (P < 0.001). The majority of patients (85%) had none of these risk factors, and no patient had para-aortic metastases in the absence of these predictors. Suspicious pelvic or para-aortic lymph nodes were present in the minority of patients (15%) and identified all patients with para-aortic metastases. Therefore, para-aortic lymphadenectomy may be safely omitted at the time of exploration for radical hysterectomy in the absence of enlarged or abnormally firm pelvic or para-aortic lymph nodes. In the presence of either of these factors or extracervical spread of disease a para-aortic lymphadenectomy is necessary to rule out metastases.