Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of discontinuing non-steroidal antiinflammatory drugs on long-term recurrence in colonic diverticular bleeding.

AIM To determine the effect of discontinuing non-steroidal antiinflammatory drugs (NSAIDs) on recurrence in long-term follow-up patients with colonic diverticular bleeding (CDB). METHODS A cohort of 132 patients hospitalized for CDB examined by colonoscopy was prospectively enrolled. Comorbidities, lifestyle, and medications (NSAIDs, low-dose aspirin, antiplatelet agents, anticoagulants, acetaminophen, and corticosteroids) were assessed. After discharge, patients were requested to visit the hospital on scheduled days during the follow-up period. The Kaplan-Meier method was used to estimate recurrence. RESULTS Median follow-up was 15 mo. The probability of recurrence at 1, 6, 12, and 24 mo was 3.1%, 19%, 27%, and 38%, respectively. Of the 41 NSAID users on admission, 26 (63%) discontinued NSAID use at discharge. Many of the patients who could discontinue NSAIDs were intermittent users, and could be switched to alternative therapies, such as acetaminophen or an antiinflammatory analgesic plaster. The probability of recurrence at 12 mo was 9.4% in discontinuing NSAID users compared with 77% in continuing users (P<0.01, log-rank test). The hazard ratio for recurrence in the discontinuing NSAIDs users was 0.06 after adjusting for age>70 years, right-sided diverticula, history of hypertension, and hemodialysis. No patients developed cerebrocardiovascular events during follow-up. CONCLUSION There is a substantial recurrence rate after discharge among patients hospitalized for diverticular bleeding. Discontinuation of NSAIDs is an effective preventive measure against recurrence. This study provides new information on risk reduction strategies for diverticular bleeding.
Simplified ultralong protocol of gonadotrophin-releasing hormone agonist for ovulation induction with intrauterine insemination in patients with endometriosis.

The present study was designed to assess the usefulness of the simplified ultralong protocol of gonadotrophin-releasing hormone agonist (GnRHa) for ovulation induction with intrauterine insemination (IUI) in patients with various stages of endometriosis. A prospective randomized trial was set up to compare the simplified ultralong protocol (ULP) and the long protocol (LP) of GnRHa for ovulation induction with IUI in patients with endometriosis. There was no evidence of other factors in infertility in any patient. In the ULP group (39 patients), 4 weeks after a single injection of 3.75 mg Decapeptyl had been given, daily s.c. administration of 0.1 mg Decapeptyl was initiated and continued for at least 2 weeks prior to ovarian stimulation. In the LP group (41 patients), daily s.c. administration of 0.1 mg Decapeptyl was initiated from the mid-luteal phase of the cycle preceding the stimulation cycle. After 14 days of administration, ovarian stimulation was started if pituitary desensitization had been achieved. The amount of gonadotrophins required, number of days of gonadotrophin administration, serum oestradiol response, and the number of mature follicles were comparable in both groups. The clinical pregnancy rate per cycle was significantly higher in the ULP group at 48.7% (19/39) compared with 26.8% (11/41) in the LP group. The miscarriage rates were 21.1% (4/19) in the ULP group and 18.2% (2/11) in the LP group. In patients with stage I or II endometriosis, there was no significant difference between the two groups with respect to clinical pregnancy rate per cycle (47.4 versus 35.0%). In patients with stage III or IV endometriosis, the clinical pregnancy rate per cycle was significantly higher in the ULP group at 50.0% (10/20) compared with 19.0% (4/21) in the LP group. This study suggests that a simplified ULP of GnRHa could give better chances of achieving pregnancy in endometriosis patients undergoing assisted reproductive technologies and that this protocol may be more useful in patients with an advanced stage of endometriosis.
Biofilms in Chronic Rhinosinusitis with Nasal Polyps

Objective. (1) Evaluate the presence of biofilms in patients with chronic sinusitis with nasal polyps (CRSwNP) and (2) investigate the association of biofilm presence and CRSwNP. Study Design. Cross-sectional study. Setting. University-based tertiary care center. Subjects and Methods. The study group consisted of 33 consecutive patients undergoing functional endoscopic sinus surgery for CRSwNP. The control group consisted of 27 control patients undergoing septoplasty for nasal obstruction without diagnosis of chronic sinusitis. Mucosal samples were harvested intraoperatively for scanning electron microscopic examination to determine biofilm presence. Statistical analysis was performed. For all statistical tests, P = . 05 was considered significant. Results. Biofilms were found in 24 (72.7%) of the 33 patients with CRSwNP and in 13 (48.1%) of the 27 septoplasty patients (odds ratio = 2.87; 95% confidence interval, 0.98-8.42; P = .051). Conclusion. (1) Biofilms were present in patients undergoing functional endoscopic sinus surgery for CRSwNP and also in controls without chronic sinusitis. This suggests that biofilms may not be sufficient to cause chronic sinusitis without other cofactors. Host factors could be the responsible for the pathogenesis of biofilms. (2) Although the prevalence of biofilms in patients with CRSwNP was not significantly different from that in the controls, the extremely wide 95% confidence interval, which is just below unity, suggests that a meaningful clinical difference may have been missed because of low statistical power. Further studies are necessary.
Coordinated deregulation of cellular receptors, proangiogenic factors and intracellular pathways in acute myeloid leukaemia

Different signaling routes seem to be simultaneously triggered in leukemia, with distinct and overlapping activities. To analyze if altered signals are coordinated and to evaluate their effect on this disease, we have investigated in acute myeloid leukemia samples (AML) the expression and activation status of procoagulant/proangiogenic tissue factor receptor (TF), angiogenic protein VEGF, its cell surface receptor, KDR, and two intracellular proteins involved in their regulation: extracellular regulated kinase (ERK1/2) and nuclear factor kappa-B (NFκB). Significantly higher mRNA and protein levels of VEGF, KDR, and TF were found in the AML samples versus controls. Enhanced ERK phosphorylation and NFκB activation in most AML samples were also found. In vitro MEK/ERK and NFκB-binding activity blockade suppressed the constitutive expression of TF, VEGF, and KDR. Anti-TF antibody treatment significantly suppressed VEGF and KDR expression as well as ERK activation, suggesting that TF expressed by AML cells may be both a regulatory target and a mediator of tumor-associated angiogenesis. Patients showing parallel activation of the studied proteins trended to exhibit higher incidence of fatal outcome. Our results show a coordinated deregulation of cellular receptors, proangiogenic factors, and intracellular pathways in leukemia cells, which may help to design mechanism-based combinations of single transduction-related therapies.
EARLY DIAGNOSIS OF HUMAN CYTOMEGALOVIRUS DISEASE IN TRANSPLANT RECIPIENTS BY DNA AMPLIFICATION IN PLASMA

Human cytomegalovirus (HCMV) infection in transplant recipients is often complicated by invasive visceral disease. The most reliable marker for HCMV disease is viremia, currently defined by detection of the virus in white blood cells. In this study we employed the polymerase chain reaction (PCR) to detect HCMV DNA in the plasma of transplant recipients. The utility of plasma PCR in the early diagnosis of active HCMV infection and disease was determined in 83 bone marrow transplant recipients and 6 kidney transplant recipients. All 46 patients who had a positive leukocyte culture were positive by plasma-PCR. PCR detection preceded culture isolation by a median interval of one week and remained positive for a longer period, with a median lag interval of two weeks in uncomplicated infection. Lack of PCR resolution predicted disease development in 11 patients and culture relapse in three. Of the 11 patients who were culture-negative but positive by plasma-PCR, 8 (73%) subsequently developed HCMV disease; 32 (74%) of 43 leukocyte culture-negative patients remained plasma PCR—negative, regardless of concomitant viral shedding in 11. In bone marrow transplant recipients, plasma PCR was associated with a positive predictive value of 60% for disease development and with a negative predictive value of 97%. PCR detection preceded disease development by a median interval of 3 weeks. Plasma PCR is a rapid, specific, and highly sensitive method for the early diagnosis of HCMV disease and should prove useful in guiding prophylactic therapy in transplant recipients.
Chitosan Scaffolds with Unidirectional Microtubular Pores for Large Skeletal Myotube Generation

O N Skeletal muscle has very limited self-repair capability, and the damage to skeletal muscle is commonly treated by surgical intervention. [ 1–3 ] The surgical treatment involves local or distant autologous muscle transposition, but is limited by the shortage of donor tissue and donor site morbidity. [ 3 ] Regeneration of functional skeletal muscle tissue in vitro may offer a clinically relevant alternative to the autografts, where an engineered scaffold uses myogenic cells derived from the patient to pre-engineer custom muscle construct for implantation. [ 4 , 5 ]
The importance of quality over in quantity in the social sharing of emotions (SSE) in people living with HIV/AIDS

Research shows that chronic illness patients encounter difficulties in the social sharing of emotions (SSE). Since most SSE studies focus on quantitative aspects, the present study, aimed, among others, to study the associations between the quality of SSE in people living with HIV/AIDS and patients’ psychological and physical well-being. A total of 101 HIV/AIDS patients answered a questionnaire (Likert scale items) which assessed: shame, guilt, perceived stigma, reasons for non-disclosure of serostatus, physical health, mental health, SSE and quality of SSE. While no associations were found between quantitative aspects of SSE, physical health and mental health, the quality of SSE was negatively correlated to shame and guilt, and positively correlated to physical and mental health. Furthermore, mediation analyses showed the mediating role of the quality of SSE in the relationship between, on the one hand, shame and guilt; and on the other hand, physical and mental health. Findings suggest the importance of qualitative aspects of SSE in the emergence of positive outcomes linked to emotional expression in people living with HIV/AIDS.
Approaches to Treatment of Unifocal Langerhans Cell Histiocytosis: Is Biopsy Alone Enough?

Background: Langerhans cell histiocytosis (LCH) is a variable disorder involving either single bone or multiorgan systems. The most effective treatment of unifocal osseous lesions is debated in the literature. This study describes the treatment approaches for LCH and demonstrates the effectiveness of biopsy in providing symptom resolution. Methods: Records of 61 patients diagnosed with LCH at a single institution over an 11-year period were reviewed. Thirty-nine patients with biopsy-confirmed diagnoses of unifocal osseous LCH were included in the analysis. At this institution, lesions are surgically treated by incisional biopsy, trocar biopsy, or curettage and grafting. Patients receive chemotherapy on a case-by-case basis, depending on the lesion location and size. A Kaplan-Meier analysis was used to compare time with symptom resolution across treatment groups. Results: In the 39 patients with unifocal osseous LCH, treatment approaches included incisional biopsy (n=18, 46.15%), trocar biopsy (n=8, 20.51%), incisional biopsy and chemotherapy (n=8, 20.51%), and biopsy with bone grafting (n=5, 12.82%). The median time from biopsy to symptom resolution was 5.43 weeks, with an average length of follow-up of 1.59 years. The median time to symptom resolution was 3.86 weeks with incisional biopsy, 5.43 weeks with biopsy and grafting, 5.64 weeks with trocar biopsy, and 16.57 weeks with biopsy and chemotherapy. Overall, there was a significant difference (P=0.0262) in the time to symptom resolution across the different treatment approaches. Time to symptom resolution was significantly different between incisional biopsy and chemotherapy treatment compared with the incisional biopsy treatment (P=0.0027), as well as biopsy with grafting treatment (P=0.0264). Conclusions: Symptom resolution occurred rapidly after biopsy and did not significantly differ among patients who received incisional biopsy, trocar biopsy, or biopsy with grafting. Unifocal osseous LCH likely does not require aggressive surgical or medical management. Biopsy alone both confirms the diagnosis and precedes a predictable resolution of symptoms. Level of Evidence: Level III, retrospective comparative therapeutic study.
Traumatic brain injury in children and adolescents: psychiatric disorders at two years.

OBJECTIVE To extend findings regarding predictive factors of psychiatric outcome from the first to the second year after traumatic brain injury (TBI) in children and adolescents. METHOD Subjects were children aged 6 to 14 years at the time they were hospitalized after TBI. The study used a prospective follow-up design. Assessments of preinjury psychiatric, behavioral, adaptive functioning, family functioning and family psychiatric history status were conducted. Severity of injury was assessed by standard clinical scales and neuroimaging was analyzed. The outcome measure was the presence of a psychiatric disorder, not present before the injury ("novel"), during the second year after TBI. RESULTS Fifty subjects enrolled, and the analyses focused on 42 subjects followed at 24 months. Severity of injury, preinjury family function, and preinjury lifetime psychiatric history predicted the development of a "novel" psychiatric disorder present in the second year. CONCLUSION These data suggest that there are children, identifiable through clinical assessment, at increased risk for "novel" psychiatric disorders in the second year after TBI.
Correlation between cognition and symptomatic severity in patients with late-life somatoform disorders

Objectives: Various aging associated factors, such as functional decline, psychosocial problems, and cognitive dysfunction, are risk factors for somatoform disorders (SDs) in the elderly. The aim of the present study was to evaluate how cognition is correlated with the severity of late-life SDs from a neuropsychological viewpoint.Methods: Fifty-three patients over 60 years of age who had been diagnosed as having SDs were examined in this study. The severity of the somatic symptoms was assessed using the Hamilton Anxiety Rating Scales (HAMA). Cognitive functions were assessed using the Mini-Mental State Examination (MMSE), the Frontal Assessment Battery (FAB), and the Japanese version of the Neurobehavioral Cognitive Examination (J-COGNISTAT). Results: The J-COGNISTAT subtest score for attention was below the cutoff point (8 points) but was not correlated with the severity of the somatic symptoms in the patients with late-life SDs. The severity of anxiety as assessed using the HAMA was significantly correlated with the calculation scores (P < 0.005) among the J-COGNISTAT subtests, the FAB total (P < 0.05), and the FAB subtest scores (similarities and motor series) (P < 0.01). Other factors, including the benzodiazepine dosage, antidepressant dosage, the duration of illness, and the onset age, were not significantly correlated with the symptomatic severities.Conclusion: Patients with late-life SDs showed attention deficits, but no correlation was seen between the attention deficits and symptomatic severities. Attention deficits might be associated with the appearance of symptoms. Executive dysfunction and working memory might be associated with the severity of symptoms.
Adenovirus‐mediated gene transfer into tendon and tendon sheath

In this study, we successfully transferred the Escherichia coli β‐galactosidase gene, LacZ, into the chicken tendon and tendon sheath by a recombinant adenovirus. The recombinant adenovirus Adv‐βgal that carried the E. coli LacZ gene was constructed by homologous recombination in 293 cells (human transformed embryonic kidney) between the expressing vector and the ClaI large fragment of adenovirus 5 genome. Each chicken received a 10 μl injection, containing 105 plaque‐forming units of recombinant virus Adv‐βgal, into the tendon sheath of the long toe. Samples of tendon and tendon sheath were harvested at 3, 30, and 75 days after the injection. The LacZ gene transfer was detected for its coding product β‐galactosidase by staining with X‐gal solution. The results showed that all tendon and tendon sheath samples from the three harvest times stained positive (blue). The tendon sheath samples were more extensively stained; staining of the tendon was limited to the epitenon layer. These data suggest that a functional exogenous gene can potentially be transferred into the tendon and tendon sheath by similar techniques; such techniques may be used to improve healing and reduce adhesion formation.
NS3 Protease Polymorphism and Natural Resistance to Protease Inhibitors in French Patients Infected with HCV Genotypes 1–5

Background Resistant HCV populations may pre-exist in patients before NS3 protease inhibitor therapy and would likely be selected under specific antiviral pressure. The higher prevalence and lower rate of response to treatment associated with HCV genotype 1 infections has led to drug discovery efforts being focused primarily on enzymes produced by this genotype. Protease inhibitors may also be useful for non-genotype-1-infected patients, notably for non-responders. Methods We investigated the prevalence of dominant resistance mutations and polymorphism in 298 HCV pro-tease-inhibitor-naive patients infected with HCV genotypes 1, 2, 3, 4 or 5. Genotype-specific NS3 primers were designed to amplify and sequence the NS3 protease gene. Results None of the 233 analysed sequences contained major telaprevir (TVR) or boceprevir (BOC) resistance mutations (R155K/T/M, A156S/V/T and V170A). Some substitutions (V36L, T54S, Q80K/R, D168Q and V170T) linked to low or moderate decreases in HCV sensitivity to protease inhibitors were prevalent according to genotype (between 2% and 100%). Other than genotype signature mutations at positions 36, 80 and 168, the most frequent substitution was T54S (4 genotype 1 and 2 genotype 4 sequences). All genotype 2–5 sequences had the non-genotype-1 signature V36L mutation known to confer low-level resistance to both TVR and BOC. Conclusions We have developed an HCV protease NS3 inhibitor resistance genotyping tool suitable for use with HCV genotypes 1–5. Polymorphism data is valuable for interpreting genotypic resistance profiles in cases of failure of anti-HCV NS3 protease treatment.
Poor Sleep Quality Diminishes Cognitive Functioning Independent of Depression and Anxiety in Healthy Young Adults

Sufficient sleep is essential for optimum cognitive and psychological functioning. Diminished sleep quality is associated with depression and anxiety, but the extent to which poor sleep quality uniquely impacts attention and executive functions independent of the effects of the common underlying features of depression and anxiety requires further exploration. Here 67 healthy young adults were given the Minnesota Multiphasic Personality Inventory, second edition (MMPI-2), the Pittsburgh Sleep Quality Index (PSQI), and tests of attention and executive functions. Similar to findings from a previous study with healthy community-based older adults (Nebes, Buysse, Halligan, Houck, & Monk, 2009), participants who reported poor sleep quality on the PSQI endorsed significantly greater scores on MMPI-2 Restructured Clinical scales related to depression and anxiety (Cohen's d = 0.77–1.05). In addition, PSQI component scores indexing poor sleep quality, duration, and medication use were associated with diminished attention and executive functions, even after controlling for emotional reactivity or demoralization (rs = 0.21–0.27). These results add to the concurrent validity of the PSQI, and provide further evidence for subtle cognitive decrements related to insufficient sleep even in healthy young adults. Future extension of these findings is necessary with larger samples and clinical comparison groups, and using objective indices of sleep dysfunction such as polysomnography.
Central nervous system complications after liver transplantation: Common but mostly transient phenomena

Although central nervous system complications (CNSCs) are common after orthotopic liver transplantation (OLT), standardized prospective studies are still lacking. This prospective study was aimed at determining the incidence of CNSCs, describing their clinical presentations, and establishing predicting factors. One hundred thirty‐six adult patients who underwent OLT at Hannover Medical School between December 2008 and June 2011 were included. Weekly examinations were performed by a neurologist during the hospital stay after OLT. Patient data, donor data, and operative and postoperative variables were collected. Patients with cerebral dysfunction after OLT underwent a diagnostic work‐up, which included brain imaging and, if necessary, cerebrospinal fluid analysis. Patients with central nervous system (CNS) symptoms but negative imaging and cerebrospinal fluid results and patients with pontine myelinolysis or posterior reversible encephalopathy syndrome were placed in a metabolic‐toxic CNSC group, and patients with strokes, intracranial hemorrhaging, or CNS infections were placed in a nonmetabolic CNSC group. Multiple regression analysis was used to identify independent risk factors for the development of metabolic‐toxic CNSCs. After excluding two patients that died after OLT without regaining consciousness, forty‐four (32.8%) patients developed CNSCs: 37 of these patients (27.6%) had metabolic‐toxic CNSCs, and 7 (5.2%) had nonmetabolic CNSCs. Acute‐on‐chronic liver failure, the number of subsequent surgeries, and primary sclerosing cholangitis were identified as independent predictors for the development of metabolic‐toxic CNSCs. Metabolic‐toxic CNSCs were associated with prolonged hospital stays, and nonmetabolic CNSCs were associated with higher mortality. In conclusion, CNSCs are common and relevant complications after OLT. Patients after OLT, especially with risk factors, should undergo a regular standardized neurological examination that would allow early detection of these complications. Liver Transpl 21:224‐232, 2015. © 2014 AASLD.
A Novel Method of Conductivity Measurements for Carbon-Fiber Monopole Antenna

The relation between loss resistance and conductivity for monopole antennas over a ground plane is derived. Its accuracy was confirmed by good agreement between it and finite element and method of moments simulations. This relation may be used to calculate conductivity of any material that radiates. A Wheeler Cap system was setup. System losses were determined by equating the loss resistance of a 70 mm long × 1.17 mm diameter copper monopole at resonance with that predicted using the published conductivity for this material. The loss resistance of a 70 mm long × 2 mm wide × 2 mm thick monopole antenna manufactured from an aerospace grade carbon fibre reinforced plastic (CFRP) laminate, IM7/977-3 prepreg tape with a [0 45 90-45]2s stacking sequence, was measured then corrected for system loss. The conductivity of the CFRP laminate was calculated to be 51,000 S/m at 980 MHz.