Miracle-dz/UniFAR-FTUs huggingface dataset:
Benign, dysplastic, or malignant--making sense of endoscopic bile duct brush cytology: results in 149 consecutive patients.

OBJECTIVES To determine the efficacy of endoscopic bile duct brush cytology for diagnosis of pancreaticobiliary malignancies and to provide guidelines for interpretation of dysplastic cytology. METHODS Consecutive endoscopic bile duct brush cytology specimens were classified by an independent cytopathologist as benign, low- or high-grade dysplasia, or cancer. A final diagnosis was established in a blinded fashion by histopathology, radiographic evidence of metastatic disease, or independent clinical follow-up. Sensitivity and specificity were adjusted for dysplastic cytology, and likelihood ratios were determined for each diagnosis and used for calculation of posttest probability of malignancy. RESULTS Dysplasia was found in 23% of 168 consecutive bile duct brushings performed in 149 patients. Sensitivity of brush cytology was 37% and specificity 100%; its likelihood ratio for malignancy ranged from 3.4 for high-grade dysplasia, to 1.1 for low-grade dysplasia, to 0.6 for benign. For a patient with a 50% pretest probability of malignancy, finding of high-grade dysplasia changed the posttest probability to 77%, low-grade dysplasia to 52%, and benign to 38%. CONCLUSION Cytological dysplasia occurs frequently, with high-grade dysplasia being strongly suggestive of malignancy. Presented likelihood ratios can be used to calculate the posttest probability of malignancy for any diagnosis.
Photopheresis in solid organ transplant rejection

Photopheresis has become a key component in the therapeutic armamentarium of cutaneous T‐cell lymphoma, graft‐versus‐host disease following stem cell transplant, and allograft rejection of solid organs such as heart. Although it is considered a new treatment modality in its present form, the field of phototherapy dates back thousands of years. In this review, the reader will learn more about the history of photopheresis and how it became a therapeutic alternative for patients with solid organ transplants. An extensive literature search will highlight the evidence‐based benefits of photopheresis (or lack thereof). A discussion of the mechanism of action of photopheresis and the technical aspects of the procedure will also be covered. Since photopheresis may be the best tolerated form of immunomodulation, current promising, albeit preliminary data on its efficacy warrant further investigation and understanding. J. Clin. Apheresis 21:72–77, 2006. © 2006 Wiley‐Liss, Inc.
Physiology, morphology and detailed passive models of guinea‐pig cerebellar Purkinje cells.

1. Purkinje cells (PCs) from guinea‐pig cerebellar slices were physiologically characterized using intracellular techniques. Extracellular caesium ions were used to linearize the membrane properties of PCs near the resting potential. Under these conditions the average input resistance, RN, was 29 M omega, the average system time constant, tau 0, was 82 ms and the average cable length, LN, was 0.59. 2. Three PCs were fully reconstructed following physiological measurements and staining with horseradish peroxidase. Assuming that each spine has an area of 1 micron 2 and that the spine density over the spiny dendrites is ten spines per micrometre length, the total membrane area of each PC is approximately 150,000 microns 2, of which approximately 100,000 microns 2 is in the spines. 3. Detailed passive cable and compartmental models were built for each of the three reconstructed PCs. Computational methods were devised to incorporate globally the huge number of spines into these models. In all three cells the models predict that the specific membrane resistivity, Rm, of the soma is much lower than the dendritic Rm (approximately 500 and approximately 100,000 omega cm2 respectively). The specific membrane capacitance, Cm, is estimated to be 1.5‐2 muF cm‐2 and the specific cytoplasm resistivity, Ri, is 250 omega cm. 4. The average cable length of the dendrites according to the model is 0.13 lambda, suggesting that under caesium conditions PCs are electrically very compact. Brief somatic spikes, however, are expected to attenuate 30‐fold when spreading passively into the dendritic terminals. A simulated 200 Hz train of fast, 90 mV somatic spikes produced a smooth 12 mV steady depolarization at the dendritic terminals. 5. A transient synaptic conductance increase, with a 1 nS peak at 0.5 ms and a driving force of 60 mV, is expected to produce approximately 20 mV peak depolarization at the spine head membrane. This EPSP then attenuates between 200‐ and 900‐fold into the soma. Approximately 800 randomly distributed and synchronously activated spiny inputs are required to fire the soma. 6. The passive model of the PC predicts a poor resolution of the spatio‐temporal pattern of the parallel fibre input. An equally sized, randomly distributed group of approximately 1% of the parallel fibres, activated within a time window of a few milliseconds, would result in approximately the same composite EPSP at the soma.
Expression and Purification of the Extracellular Ligand Binding Region of Metabotropic Glutamate Receptor Subtype 1*

Each metabotropic glutamate receptor possesses a large extracellular domain that consists of a sequence homologous to the bacterial periplasmic binding proteins and a cysteine-rich region. Previous experiments have proposed that the extracellular domain is responsible for ligand binding. However, it is currently unknown whether the extracellular ligand binding site can bind ligands without other domains of the receptor. We began by obtaining a sufficient amount of receptor protein on a baculovirus expression system. In addition to the transfer vector that encodes the entire coding region, transfer vectors that encode portions of the extracellular domain were designed. Here, we report a soluble metabotropic glutamate receptor that encodes only the extracellular domain and retains a ligand binding characteristic similar to that of the full-length receptor. The soluble receptor secreted into culture medium showed a dimerized form. Furthermore, we have succeeded in purifying it to homogeneity. Dose-response curves of agonists for the purified soluble receptor were examined. The effective concentration for half-maximal inhibition (IC50) of quisqualate for the soluble receptor was 3.8 × 10−8 m, which was comparable to that for the full-length receptor. The rank order of inhibition of the agonists was quisqualate ≫ ibotenate ≥l-glutamate ≈ (1S,3R)-1-aminocyclopentane-1,3-dicarboxylic acid. These data demonstrate that a ligand binding event in metabotropic glutamate receptors can be dissociated from the membrane domain.
Role of bile bacteria in gallbladder carcinoma.

BACKGROUND/AIMS Long standing calculus disease has been observed to be a risk factor for gallbladder carcinoma. However it is possible that calculi may be incriminated by some means other than just chronic irritation. Calculi may induce an element of stasis, promoting chronic infection leading to increased turnover of primary bile acids to secondary bile acids, which are known tumor promoters and initiators. This study aimed to find the prevalence of biliary microflora in gallbladder carcinoma and association of gallbladder carcinoma with chronic bacterial infection and bile acid profile. METHODOLOGY Bile culture was done in 390 patients divided into 3 groups--gallbladder carcinoma 65 (17%), cholelithiasis 125 (32%) and control group 200 (51%). Serum samples were analyzed for presence of Vi antibody for chronic typhoid carrier state and bile acid analysis was done in 10 patients in each group. RESULTS 116 (30%) patients had culture positive bile. Significantly higher number of patients with gallbladder carcinoma 40 (65%) had culture positive bile as compared to cholelithiasis 52 (42%) and control 24 (12%). Vi Antibodies suggestive of chronic typhoid carrier state were found to be significantly higher in the gallbladder carcinoma group 20 (31%) as compared to controls 22 (11%) (OR 3.596, p < 0.05) however, the difference was statistically insignificant in the cholelithiasis group 12 (11%) (OR 0.859, p > 0.05). There was a 6.84 times higher risk of developing gallbladder carcinoma in culture positive cholelithiasis patients and 5.14 times if both Vi antibody and cultures were positive. Bile analysis showed primary bile acids cholic acid and chenodeoxycholic acid to be lower while secondary bile acids deoxycholic acid and lithocholic acid to be more in the gallbladder carcinoma group (7.268 mg/mL, 9.183 mg/ mL, 14.468 mg/mL, 3.312 mg/mL respectively) than cholelithiasis (17.50 mg/mL, 13.80 mg/mL, 6.07 mg/ mL, 2.05 mg/mL) and control group (19.85 mg/mL, 16.53 mg/mL, 2.71 mg/mL, 1.128 mg/mL respectively). The difference was statistically significant. CONCLUSIONS Chronic bacterial infection of bile leading to production of carcinogenic precursors might be one of the etiological factors in the pathogenesis of gallbladder carcinoma and hence a target for its prevention.
Interleukin-6 identified as an important factor in hypoxia- and aldehyde dehydrogenase-based gefitinib adaptive resistance in non-small cell lung cancer cells

Gefitinib resistance and relapse of the disease were the greatest challenges facing clinical therapy of non-small-cell lung cancer (NSCLC). Of note, regarding the hypoxia condition in solid tumor tissues in vivo, roles of hypoxia in gefitinib adaptive resistance and its association with lung cancer stem cells (LCSCs) have not been fully elucidated. In the present study, the role of hypoxia in gefitinib adaptive resistance and its association with aldehyde dehydrogenase (ALDH)-based LCSC gefitinib resistance were comparatively studied using RNA-sequencing (RNA-seq) technology. Co-treatment of PC9 cells with gefitinib and hypoxia (1% O2) significantly enhanced adaptive resistance compared with gefitinib or hypoxia treatment alone. An ALDEFLUOR assay demonstrated that there was a significant increase of ALDH expression level in hypoxia and gefitinib co-treated PC9 cells, in addition to a higher ratio of G0/G1 quiescent cell enrichment and acquisition of epithelial-mesenchymal transition. RNA-seq analysis revealed that interleukin-6 (IL-6) is an important common factor in hypoxia and ALDH-based gefitinib resistance, supported by inflammation-associated tumor necrosis factor, nuclear factor-κB and Janus kinase-signal transducer and activator of transcription signaling pathway enrichment. Furthermore, exposure of PC9 and HCC827 cells to IL-6 increased gefitinib adaptive resistance. Consequently, IL-6 expression level was a poor prognostic marker for patients with NSCLC and adenocarcinoma. Thus, targeting IL-6 combined with tyrosine kinase inhibitor treatment may be promising in NSCLC clinical therapy in the future.
Law and administration in Europe : essays in honour of Carol Harlow

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What role do professional year programs play in developing work-readiness attributes for Australian-educated international postgraduate students?

In 2008, following Commonwealth legislation creating the 485 Graduate Visa for migration purposes, the professional accrediting bodies in Accounting, IT and Engineering were mandated to develop Professional Year Programs (PYPs) intended to alleviate the gap between discipline specific qualifications and the skills required to meet employer demands. This research conducted a critical examination of one such program: SMIPA, the Skilled Migration Program for Accounting. This was a work readiness program for international accounting graduates who studied for their accounting degrees onshore within the Australian higher education ecosystem. The primary research question framing this research: Can SMIPA be regarded as a work-readiness program upon which to model future graduate training programs? Underpinned by Bourdieu’s institutionalised capital framework, a tripartite qualitative evaluation is undertaken through multiple lenses: 337 SMIPA graduate survey responses, semi-structured interviews with six SMIPA licenced partners and a sixty-minute interview with an early Joint Accounting Body initiator. The aim of the research is to determine the role SMIPA plays in providing graduates an opportunity to improve their generic skills, so as to find work within the Australian accounting environments. The intent is to analyse whether this program offers a blue print to model the implementation of future work readiness programs. Five recommendations for the future directions of the internship component of the SMIPA program are provided, along with recommendations for future research opportunities. It is concluded that with some significant modifications to defined measurements of the program’s intended learning outcomes, a transparent process for assessing the procurement and delivery of the internship component, as well as a far more rigorous quality assurance of the operations component that would curtail the more extreme migration and educational agent practices, SMIPA could be considered a suitable model to inform a national work integrated learning program providing a blueprint to better prepare both domestic and international tertiary educated graduates for entry into the 21st century global workforce.
Prevalence and development of psychiatric disorders in childhood and adolescence.

BACKGROUND This longitudinal community study assessed the prevalence and development of psychiatric disorders from age 9 through 16 years and examined homotypic and heterotypic continuity. METHODS A representative population sample of 1420 children aged 9 to 13 years at intake were assessed annually for DSM-IV disorders until age 16 years. RESULTS Although 3-month prevalence of any disorder averaged 13.3% (95% confidence interval [CI], 11.7%-15.0%), during the study period 36.7% of participants (31% of girls and 42% of boys) had at least 1 psychiatric disorder. Some disorders (social anxiety, panic, depression, and substance abuse) increased in prevalence, whereas others, including separation anxiety disorder and attention-deficit/hyperactivity disorder (ADHD), decreased. Lagged analyses showed that children with a history of psychiatric disorder were 3 times more likely than those with no previous disorder to have a diagnosis at any subsequent wave (odds ratio, 3.7; 95% CI, 2.9-4.9; P<.001). Risk from a previous diagnosis was high among both girls and boys, but it was significantly higher among girls. Continuity of the same disorder (homotypic) was significant for all disorders except specific phobias. Continuity from one diagnosis to another (heterotypic) was significant from depression to anxiety and anxiety to depression, from ADHD to oppositional defiant disorder, and from anxiety and conduct disorder to substance abuse. Almost all the heterotypic continuity was seen in girls. CONCLUSIONS The risk of having at least 1 psychiatric disorder by age 16 years is much higher than point estimates would suggest. Concurrent comorbidity and homotypic and heterotypic continuity are more marked in girls than in boys.
Risk factors for hepatocellular carcinoma among patients with chronic liver disease.

BACKGROUND AND METHODS To detect potentially curable cases of hepatocellular carcinoma, outpatients with chronic hepatitis or compensated liver cirrhosis who were seen at the Center for Adult Diseases (Osaka, Japan) were examined periodically by means of ultrasonography and measurement of serum alpha-fetoprotein. Risk factors for hepatocellular carcinoma were identified with a Cox proportional-hazards model. RESULTS A total of 917 patients, 40 to 69 years old, were registered from May 1987 to March 1991. By the end of September 1991, liver cancer had developed in 54. The three-year cumulative risk of liver cancer was 12.5 percent for 240 patients with liver cirrhosis at enrollment and 3.8 percent for 677 patients with chronic hepatitis. Cox regression analysis showed that the risk of liver cancer was increased almost sevenfold in patients with hepatitis B surface antigen (rate ratio, 6.92; 95 percent confidence interval, 2.92 to 16.39) and fourfold in patients with hepatitis C antibody (rate ratio, 4.09; 95 percent confidence interval, 1.30 to 12.85). A high alpha-fetoprotein value at enrollment was also a risk marker for liver cancer. CONCLUSIONS Patients with hepatitis C virus infection have a greatly increased risk of liver cancer. Further studies are required to clarify the roles of other risk factors, including drinking and smoking habits.
Correlates of HIV testing among South African women with high sexual and substance-use risk behaviours

Abstract Despite its importance in raising awareness of HIV risk behaviour and in linking HIV-positive individuals to care and treatment, research findings indicate that the HIV antibody testing rate in the general South African population remains relatively low, although knowledge of HIV testing services is high. The identification of important correlates of testing behaviour can be used to improve HIV testing campaigns by refining messages that target individuals at highest risk for infection. This study uses data from an ongoing prevention intervention study in Pretoria, South Africa to identify factors that may have a greater influence on facilitating or hindering HIV testing among South African women who face a high risk for infection. The data for this study (n=425) are derived from the baseline interviews and HIV test results collected between June 2004 and January 2007. HIV testing for this study was significantly associated with education level, alcohol and cannabis use, sex trading, number of STI symptoms, physical abuse and number of visits to a clinic for medical treatment. Results suggest that more focused efforts need to be made to provide HIV testing to women who report substance use behaviour, experience violence and report high-risk sexual behaviour. Interventions also need to address denial of HIV infection and fear to test for HIV.
Treatment of iatrogenic femoral arterial pseudoaneurysms: comparison of US-guided thrombin injection with compression repair.

PURPOSE To evaluate and compare the treatment of iatrogenic femoral arterial pseudoaneurysms by using ultrasonographically (US) guided direct thrombin injection with US-guided compression repair. MATERIALS AND METHODS Twenty-six patients with iatrogenic femoral arterial pseudoaneurysms were treated with direct thrombin injection. With US guidance, a 22-gauge needle was placed into the pseudoaneurysm flow lumen and thrombin (mean volume, 0.35 mL; range, 0.10-0.60 mL) was injected with continuous color Doppler US guidance. Demographics, clinical variables, pseudoaneurysm characteristics, and results in these patients were compared with those in 281 consecutive patients who underwent US-guided compression repair. RESULTS The success rate of thrombin injection was 96% (25 of 26 patients), which was significantly higher than that of compression, 74% (209 of 281 patients) (P =.013). Twenty of 26 (77%) patients required a single injection, and six (23%) required two injections. Mean thrombosis time for thrombin injection was 6 seconds, compared with 41.5 minutes for compression. For thrombin injection, there were no complications, foot pulses did not change and no patients required conscious sedation. Follow-up US at 24 hours showed no recurrent pseudoaneurysms. CONCLUSION For the treatment of iatrogenic femoral arterial pseudoaneurysms, thrombin injection with US guidance appears to be superior to compression repair.
Ferritin levels in the cerebrospinal fluid and restless legs syndrome: effects of different clinical phenotypes.

STUDY OBJECTIVE To determine whether patients with restless legs syndrome (RLS) and controls differ in regard to levels of ferritin and transferrin in the cerebrospinal fluid (CSF) when samples are collected at night, to determine whether patients with early-onset and late-onset RLS show a different outcome for CSF values, and to determine whether the CSF ferritin level correlates with disease severity. DESIGN Collection of CSF and plasma; assessment of disease severity using objective (periodic limb movements) and subjective (Johns Hopkins Restless Legs Severity Scale) measures of severity. SETTING General Clinical Research Center. PARTICIPANTS Thirty subjects with idiopathic RLS (15 early- and 15 late-onset RLS) and 22 age- and sex-matched controls. INTERVENTION N/A. RESULTS Nighttime CSF ferritin levels were lower in the total RLS group compared with controls. Further assessment found that the early-onset (less than 45 years of age) but not the late-onset (greater than or equal to 45 years of age) RLS group had significantly lower CSF ferritin levels compared with controls. There was a strong correlation between the age of symptom onset and CSF ferritin values (r = 0.64): the earlier the age, the lower the ferritin level. A regression analysis showed that both sex and RLS subtype had significant effects on the CSF ferritin level, with women with early-onset RLS having substantial lower values than men with late-onset RLS. A comparison between these nighttime CSF values and previously published daytime samples suggests that diurnal changes may have effects on the findings. CONCLUSIONS This study is distinct in showing that the degree of the CSF-ferritin effect is best defined by the clinical phenotypes of sex and age of symptom onset and by the time of day that samples are collected.
Bone marrow and blood involvement by lymphoma in relationship to the lukes—collins classification

The incidence, pattern, extent, and morphology of bone marrow involvement in 176 cases of non‐Hodgkin's lymphoma (NHL) were studied in relationship to the Lukes‐Collins classification. Ninety percent of the cases were B‐cell lymphomas; 10% were T‐cell lymphomas. In 53% of cases there was bone marrow involvement by lymphoma at diagnosis. Marrow involvement was most frequently found in the small lymphocyte (B), small cleaved follicular center cell (FCC), and convoluted lymphocyte lymphomas. Frequently, the extent of bone marrow biopsy replacement by lymphoma was less than 30%; the pattern of infiltration was predominantly focal (70%). Cytologic agreement between lymph node and bone marrow specimens was always present in small lymphocyte (B), small noncleaved FCC, convoluted lymphocyte, and lymphoepithelioid cell lymphomas. Cytologic diversity between lymph node and marrow was noted in 20% of small cleaved FCC, 40% (2/5) of large cleaved FCC, and 38% (3/8) of large noncleaved FCC lymphomas. In 79% of all involved cases, both bone marrow biopsy sections and aspirate smears were diagnostic of NHL; only biopsy sections were positive in 18%, and only smears were positive in 3%. The Lukes‐Collins classification predicts a high incidence of bone marrow involvement for small lymphocyte (B), small cleaved FCC, and convoluted lymphocyte lymphomas.