Miracle-dz/UniFAR-FTUs huggingface dataset:
Surgical Management of Crohn's Disease: Influence of Disease at Margin of Resection

To determine the influence of microscopic disease at an anastomosis following intestinal resection for Crohn's disease, 97 patients undergoing 103 resections were reviewed. Most resections (85/103) involved both small and large bowel and were followed by an ileocolic anastomosis. All resection margins were available and were reviewed. In 52 instances there was no evidence of Crohn's disease at the margins. In 51 instances histologie evidence of Crohn's disease varying from chronic inflammation to tissue destruction was present in one or both margins. The incidence of immediate postoperative anastomotic complications (leak with fistula or abscess, or obstruction) was identical in patients with microscopically normal margins (3/52; 6%) and in patients with microscopic Crohn's disease at the margins (3/51; 6%). The patients were followed for a mean of 5.4 ± 4.2 years. A clinical recurrence developed during the follow-up period in 50% (26/52) of those patients with normal margins, and in 61% (31/51) of those patients with involved margins. A suture line recurrence developed in 35% (18/52) and required reoperation in 17% (9/52) of those patients with microscopically normal margins. A suture line recurrence developed in 41% of the patients (21/51) and required reoperation in 24% (12/51) of those with microscopically involved margins. None of these differences are statistically significant. The presence or absence of microscopic disease at the anastomosis did not appear to influence immediate anastomotic wound healing or long-term recurrence rates. We therefore recommend conservative resections for Crohn's disease to achieve grossly uninvolved margins rather than the sacrifice of normal bowel to achieve histologically normal margins.
Global variation in the prevalence and incidence of major depressive disorder: a systematic review of the epidemiological literature

Background Summarizing the epidemiology of major depressive disorder (MDD) at a global level is complicated by significant heterogeneity in the data. The aim of this study is to present a global summary of the prevalence and incidence of MDD, accounting for sources of bias, and dealing with heterogeneity. Findings are informing MDD burden quantification in the Global Burden of Disease (GBD) 2010 Study. Method A systematic review of prevalence and incidence of MDD was undertaken. Electronic databases Medline, PsycINFO and EMBASE were searched. Community-representative studies adhering to suitable diagnostic nomenclature were included. A meta-regression was conducted to explore sources of heterogeneity in prevalence and guide the stratification of data in a meta-analysis. Results The literature search identified 116 prevalence and four incidence studies. Prevalence period, sex, year of study, depression subtype, survey instrument, age and region were significant determinants of prevalence, explaining 57.7% of the variability between studies. The global point prevalence of MDD, adjusting for methodological differences, was 4.7% (4.4–5.0%). The pooled annual incidence was 3.0% (2.4–3.8%), clearly at odds with the pooled prevalence estimates and the previously reported average duration of 30 weeks for an episode of MDD. Conclusions Our findings provide a comprehensive and up-to-date profile of the prevalence of MDD globally. Region and study methodology influenced the prevalence of MDD. This needs to be considered in the GBD 2010 study and in investigations into the ecological determinants of MDD. Good-quality estimates from low-/middle-income countries were sparse. More accurate data on incidence are also required.
Changements sémantiques et cognition : différentes méthodes pour différentes échelles temporelles

L'avenement de la linguistique cognitive au debut des annees 1980 a represente un tournant dans l'etude des changements semantiques, en apportant un cadre theorique permettant une approche explicative supplantant les approches descriptives anterieures. Neanmoins, en depit des avancees theoriques, les procedes methodologiques sous-tendant les etudes sur les changements semantiques sont restes inchanges : analyse des manifestations synchroniques, c'est-a-dire de la polysemie a l'interieur d'une langue ou des groupes de cognats a l'interieur d'une famille linguistique, et, le cas echeant, recherche dans des corpus des developpements semantiques. L'objectif de cette these est de montrer que d'autres voies methodologiques sont possibles. Nous en proposons trois, chacune s'appliquant a des profondeurs historiques differentes. La premiere marie les concepts de la sociolinguistique variationniste a des methodologies issues de l'anthropologie quantitative afin d'observer un changement semantique en cours de realisation. La seconde est un modele multi-agents dans la lignee de la linguistique evolutionnaire qui nous de permet d'etudier des changements semantiques se deroulant sur plusieurs generations de locuteurs. Enfin, La troisieme s'appuie sur des reseaux lexicaux construits a partir de corpus de chinois couvrant une periode de 3000 ans pour quantifier les relations entre frequence, polysemie et evolution semantique.
Preoperative echocardiographic evaluation of patients referred for lung volume reduction surgery.

BACKGROUND The most efficient preoperative assessment for lung volume reduction surgery (LVRS) in patients with advanced emphysema is undefined. This study analyzed the preoperative assessment of patients by surface echocardiography (without and with dobutamine infusion), the results of which were used to exclude patients with significant pre-existing cardiac disease, a contraindication to LVRS, from the surgery. SETTING A university-based, tertiary care referral center. METHODS Patients with emphysema who met initial LVRS screening criteria underwent resting and stress surface echocardiography with Doppler imaging. Patients were evaluated prospectively for perioperative cardiac complications. RESULTS Between July 1994 and December 1996, 503 candidates for LVRS were evaluated. Of these, 207 patients (81.8%) who had echocardiography performed at our institution formed the primary study group. Images were adequate for the analysis of chamber sizes and function in 206 patients (99.5%) undergoing resting echocardiography, and the images were adequate for wall motion analysis in 172 of 174 patients (98.9%) undergoing functional testing. Right heart abnormalities were common (40.1%). Significant pulmonary hypertension (> 35 mm Hg) was uncommon (5 patients, 5.4%) among the 92 patients who subsequently underwent right heart catheterization. Occult ischemia, left ventricular dysfunction, and valvular abnormalities also were uncommon. Thus, although Doppler imaging estimates of right ventricular systolic pressure were imperfect, echocardiographic findings of normal right heart anatomy and function excluded significant pulmonary hypertension. Ninety patients (43%) eventually underwent LVRS (70 bilateral and 20 unilateral). A total of 13 perioperative cardiac events occurred in 10 patients, 6 of whom had undergone preoperative echocardiography. No patient suffered acute myocardial infarction or cardiac death. CONCLUSIONS Despite potential limitations due to severe obstructive lung disease, surface echocardiographic imaging is a feasible, noninvasive tool in this patient population to identify patients with evidence of cor pulmonale that suggests pulmonary hypertension. The routine use of surface resting and stress echocardiography for preoperative screening obviates the need for invasive right heart catheterization in many patients and results in a low incidence of significant perioperative cardiac complications.
Effect of Sample Concentration on the Determination of the Anisotropy Constant of Magnetic Nanoparticles

Techniques such as equilibrium (DC) and dynamic (AC) magnetic measurements have been used to determine the anisotropy constant of a variety of magnetic nanoparticles, obtaining values that are often an order of magnitude higher than the corresponding bulk material. Unfortunately, the effect of particle-particle interactions is often neglected, hence the reported values are an effective collective parameter , rather than an intrinsic property. In this study we used DC and AC magnetic measurements to determine the anisotropy constant of magnetic nanoparticles fixed in a cross-linked polymer matrix. We used nanoparticle concentrations of 0.1%, 1%, 6%, and 33%(w/w) in order to determine the effect of concentration, and hence interactions, on the value determined for the anisotropy constant. The effect of interaction on determining the magnetocrystalline anisotropy constant was accounted for by using the Ne? el and Vogel-Fulcher relaxation models, the latter with an effective interaction temperature determined from independent measurements. A decrease in the anisotropy constant determined from these measurements was observed with decreasing particle concentration from ~ 6100 kerg/cm3 to ~ 500 kerg/cm3 using the Vogel-Fulcher model and from ~ 9100 kerg/cm3 to ~ 1100 kerg/cm3 using the Ne? el model. The values obtained for the most dilute samples using the Vogel-Fulcher model are of comparable magnitude to bulk values for magnetite. More importantly, the value of ? 0 obtained from AC susceptibility decreased from 10-32 to 10-9 s with decreasing particle concentration. As ? 0 is expected to be of the order of 10-9 s, these results indicate that the value of magnetic anisotropy determined for the dilute sample represents an intrinsic rather than effective property. These measurements and analysis illustrate the importance of particle concentration/interactions in determining the intrinsic magnetic properties of nanoparticles, particularly the anisotropy constant .
Non-concordance in amblyopia treatment: The effective use of ‘smileys’

PURPOSE The success of any specific occlusion regimen is limited by the level of concordance, which is difficult to measure accurately in patching treatment. The aim of this study was to investigate prospectively the concordance rate of a group of children with strabismic and/or anisometropic amblyopia using a schematic diary based on completing ‘smiley’ images, filled in by the child under parental supervision, and to assess the effect of correlates such as initial visual acuity, age, and total and daily occlusion time on concordance. METHODS We recruited 51 amblyopic children aged 13 months to 12 years (mean 6.57 ± 2.82). The median duration of treatment was 16 weeks. Non-concordance was defined as occluding less than 75% of the prescribed time and was analyzed using a concordance index calculated from occlusion time recorded in the diary / prescribed occlusion time. RESULTS Of the 51 patients followed prospectively, 12 (23.5%) failed to return their diaries (Group 1); 27 (52.9%) complied with occlusion (Group 2); and 12 (23.5%) failed to comply with occlusion completely (Group 3). The total proportion of non-concordance was 47.1% (Group1 + Group 3). Concordance was not significantly related to initial visual acuity (r = -0.22, p = 0.19), patient age (F = 1.0787, p = 0.349) or total occlusion time (X 2 = 2.779, p = 0.249), but the number of daily occlusion hours showed significant difference in Group 1 (X 2 = 15.894, p = 0.000). When the three groups were compared for change in visual acuity, a significant difference was found between group 1 and group 2 (X 2 = 6.125, p = 0.047). CONCLUSION The substantial proportion of non-concordance in our study suggests that, although useful for recording purposes, parental diaries may not be stimulating enough to increase the overall level of concordance. Therefore, other forms of monitoring need to be explored.
Principal Component Analysis and Molecular Characterization of Reniform Nematode Populations in Alabama

U.S. cotton production is suffering from the yield loss caused by the reniform nematode (RN), Rotylenchulus reniformis. Management of this devastating pest is of utmost importance because, no upland cotton cultivar exhibits adequate resistance to RN. Nine populations of RN from distinct regions in Alabama and one population from Mississippi were studied and thirteen morphometric features were measured on 20 male and 20 female nematodes from each population. Highly correlated variables (positive) in female and male RN morphometric parameters were observed for body length (L) and distance of vulva from the lip region (V) (r = 0.7) and tail length (TL) and c′ (r = 0.8), respectively. The first and second principal components for the female and male populations showed distinct clustering into three groups. These results show pattern of sub-groups within the RN populations in Alabama. A one-way ANOVA on female and male RN populations showed significant differences (p ≤ 0.05) among the variables. Multiple sequence alignment (MSA) of 18S rRNA sequences (421) showed lengths of 653 bp. Sites within the aligned sequences were conserved (53%), parsimony-informative (17%), singletons (28%), and indels (2%), respectively. Neighbor-Joining analysis showed intra and inter-nematodal variations within the populations as clone sequences from different nematodes irrespective of the sex of nematode isolate clustered together. Morphologically, the three groups (I, II and III) could not be distinctly associated with the molecular data from the 18S rRNA sequences. The three groups may be identified as being non-geographically contiguous.
Cancer risk variation in BRCA1/2 mutation families

BRCA1/2 mutation carriers are at a significantly increased risk for breast and ovarian cancer as compared to women in the general population. The cancer risk estimates for mutation carriers show however considerable variation. More accurate, personal risk estimation would be beneficial for counseling and decision making regarding breast cancer screening and preventive surgery. The aim of this thesis was to improve the breast and ovarian cancer risk estimates for BRCA1/2 carriers and their female relatives, by explaining the risk variation and developing subgroup specific risk estimates. Therefore methodology and population characteristics – i.e. mutation status, mutation spectrum, family history, birth cohort – were assessed in families that were referred for genetic testing. The results showed that the reported variation in cancer risk estimates for BRCA1/2 carriers is mainly due to differences in the applied methodology, whereas differences between women have a smaller effect. Non-carriers in BRCA1/2 families appeared to be at a slightly increased risk for breast cancer in their forties as compared to the general population. Differences in the mutation spectrum only partially explained the regional differences among Dutch carriers, and the breast cancer risk did not depend on whether the mutation was paternally or maternally inherited. The breast cancer risk in mutation carriers above age 60 was still significantly increased, and annual screening detected their tumors in a more favorable stage. Application of the above findings will improve risk counselling of BRCA1/2 mutation carriers, and further evaluation of the breast screening protocols in these families is warranted to optimized surveillance.
Accuracy of Soluble Endoglin for Diagnosis of Preeclampsia and its Severity

Background: The use of biomarkers for diagnosis of Preeclampsia (PE), a life-threatening pregnancy disorder, could reduce serious complications of this disease. In this study, we investigated dysregulation of endoglin (Eng) expression and diagnostic accuracy of soluble endoglin (sEng) in PE patients. Methods: For this case-control study, 26 mild and 15 severe preeclamptic women along with 20 normotensive controls were recruited. The expression level of Eng (the co-receptor of TGF-β1) was evaluated using qRT-PCR. Also, the serum concentration of soluble Eng and expression of membranous Eng were determined by ELISA and immunohistochemistry. Results: A significant up-regulation in Eng mRNA and sEng levels was observed in PE patients versus normal controls. Immunohistochemistry (IHC) showed up-regulation of membranous Eng staining in syncytiotrophoblast and cytotrophoblast cells of PE patients. The serum levels of sEng were significantly increased in all patients (mild, sever, early- and late-onset) as compared to healthy pregnant women (P<0.001). Receiver-operating characteristic (ROC) curve analysis revealed that sEng had the highest accuracy in distinguishing PE from normal pregnancies with cut-off value of 20.4, sensitivity of 92.1%, specificity of 90%, and area under the curve (AUC) of 0.94 (95% CI: 0.88-1.00). Conclusions: Our data showed that the up-regulation of Eng mRNA along with its membranous and soluble form in PE patients leads to defect in angiogenesis pathway. Also, the results of this study revealed sEng potential as a marker for diagnosis of PE and its severity.
Cerebrospinal Fluid-Infiltrating CD4+ T Cells Recognize Borrelia burgdorferi Lysine-Enriched Protein Domains and Central Nervous System Autoantigens in Early Lyme Encephalitis

ABSTRACT Neurological manifestations of Lyme disease are usually accompanied by inflammatory changes in the cerebrospinal fluid (CSF) and the recruitment of activated T cells into the CSF compartment. In order to characterize the phenotype and identify target antigens of CSF-infiltrating T cells in early neuroborreliosis with central nervous system (CNS) involvement, we combined T-cell cloning, functional testing of T-cell responses with positional scanning synthetic combinatorial peptide libraries, and biometric data analysis. We demonstrate that CD4+ gamma interferon-producing T cells specifically responding to Borrelia burgdorferi lysate were present in the CSF of a patient with acute Lyme encephalitis. Some T-cell clones recognized previously uncharacterized B. burgdorferi epitopes which show a specific enrichment for lysine, such as the heat shock-induced chaperone HSP90. Degenerate T-cell recognition that included T-cell responses to borrelia-specific and CNS-specific autoantigens derived from the myelin protein 2′,3′-cyclic nucleotide 3′-phosphodiesterase (CNPase) could be demonstrated for one representative clone. Our results show that spirochetal antigen-specific and Th1-polarized CD4+ lymphocytes infiltrate the CSF during monophasic CNS symptoms of Lyme disease and demonstrate that cross-recognition of CNS antigens by B. burgdorferi-specific T cells is not restricted to chronic and treatment-resistant manifestations.
The Ciliary Neurotrophic Factor/Leukemia Inhibitory Factor/gp130 Receptor Complex Operates in the Maintenance of Mammalian Forebrain Neural Stem Cells

The cytokines that signal through the common receptor subunit gp130, including ciliary neurotrophic factor (CNTF), interleukin-6, leukemia inhibitory factor (LIF) and oncostatin M, have pleiotropic functions in CNS development. Given the restricted expression domain of the CNTF receptor α (CNTFR) in the developing forebrain germinal zone and adult forebrain periventricular area, we have examined the putative role of CNTFR/LIFR/gp130-mediated signaling in regulating forebrain neural stem cell fate in vivo and in vitro. Analysis ofLIFR-deficient mice revealed that a decreased level of LIFR expression results in a reduction in the number of adult neural stem cells. In adult LIFR heterozygote (+/−) mice, the number of neural stem cells and their progeny in the forebrain subependyma and TH-immunoreactive neurons in the olfactory bulb were significantly reduced. Intraventricular infusion of CNTF into the adult mouse forebrain, in the absence or presence of epidermal growth factor (EGF), enhanced self-renewal of neural stem cells in vivo. Analyses of EGF-responsive neural stem cells proliferating in vitro found that CNTF inhibits lineage restriction of neural stem cells to glial progenitors, which in turn results in enhanced expansion of stem cell number. These results suggest that CNTFR/LIFR/gp130-mediated signaling supports the maintenance of forebrain neural stem cells, likely by suppressing restriction to a glial progenitor cell fate.
Systemic lupus erythematosus increases the risks of deep vein thrombosis and pulmonary embolism: a nationwide cohort study

Studies on the risks of deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients with systemic lupus erythematosus (SLE) are limited. We evaluated the effects of SLE on the risks of developing DVT and PE in a nationwide, population‐based cohort study in Taiwan.
Estimating the influence of cochlear implantation on language development in children

Research studies reviewed here have identified a wide variety of factors that may influence a child's auditory, speech and language development following cochlear implantation. Intrinsic characteristics of the implanted child, including gender, family socioeconomic status, age at onset of hearing loss and pre-implant residual hearing may predispose a child to greater or lesser post-implant benefit. Intervention characteristics that may influence outcome include age of the child when deafness is identified and amplification and habilitation is initiated, the communication mode used with the child and the type of classroom/therapy employed. Characteristics of the implant itself include generation of technology used, the age of the child when implant stimulation is initiated, and the amount of time the child has used the implant. These factors interact in unpredictable ways, so that isolated correlations between predictor variables and outcome scores may be difficult to interpret. Results for two independent samples of children tested by different laboratories were compared using multiple regression analysis to take into account relationships among predictor variables. Implant age was a significant predictor, and children in both samples who received a cochlear implant sometime between their first and second birthday achieved oral receptive vocabulary levels within one standard deviation of hearing age-mates. Age at implant accounted for a similar proportion of variance in receptive vocabulary outcome scores in each sample. A unique predictor was then added to each analysis. The addition of pre-implant aided threshold not only increased the total predicted variance, but also increased the effect of implant age as a predictor variable. A different result was observed in the other sample, when the added predictor variable was non-verbal IQ, where the estimated contribution of implant age was reduced. Future studies are advised to control for independent contributions of implant age, non-verbal IQ, and pre-implant aided thresholds when examining expected outcomes.