Miracle-dz/UniFAR-FTUs huggingface dataset:
An unusual dark pigmentation on the tympanic membrane

Abstract Objective: To report an extremely rare case of dark pigmentation on the tympanic membrane due to alkaptonuria, and to discuss the probable association between this condition and hearing loss. Case report: A 58-year-old man with alkaptonuria was admitted with tinnitus and hearing loss in both ears. Physical examination showed bluish-black pigmentation on the helixes of both ears and both sclerae. Otoscopic examination revealed dark discolouration of both tympanic membranes. Audiological evaluation revealed mixed high frequency hearing loss in both ears. Tympanometric examination revealed type A tympanograms bilaterally, and absence of acoustic reflexes both ipsilaterally and contralaterally. Computed tomography of the temporal bones revealed no abnormality. Conclusion: Clinicians should consider alkaptonuria in the differential diagnosis of patients with abnormal tympanic membrane pigmentation and hearing loss.
Interpersonal interaction and personality change in group psychotherapy.

In recent years many of the traditional assumptions about the nature of psycho­ therapy have been subjected to new and critical scrutiny. One of the challenged as­ sumptions is concerned with insight as a crucial condition for personality change. For example, Collier (3), and Mendelsohn, Yates and Peterson (14) have contended that strong positive affect is more important than insight. Mellinger (13) has stressed trust. Coons (5, 4) has claimed that inter­ personal interaction in a warm accepting environment is the dynamic of change. Strupp (20) has noted that therapist warmth toward patients is accompanied by more favourable diagnostic and prognostic expect­ ations and greater communication of em­ pathy. And Snyder's (19) term 'relationship' seems to refer to much the same phe­ nomenon. Concurrent with the challenge to the traditional explanations of the nature of psychotherapy has been an increasing con­ cern about who can be therapists. Albee (1) and Schofield (18) have stressed the impor­ tance of finding alternatives to psycho­ therapy given by professionals. Rioch and her colleagues (16), and Carkhuff and Truax (2) have adduced evidence that, with training, nonprofessionals can be effective thera­ pists, while Poser (15) has made the same claim for therapists with no training or special knowledge. These developments have important im­ plications for the practice of psychotherapy and for the organization of hospital therapy programs. If positive affect or trust or interpersonal interaction can produce per­ sonality change, and if untrained therapists
Reference intervals for serum cystatin C in healthy Mexican adults

Glomerular filtration rate (GFR) remains the most accurate predictor for assessing kidney function. Serum creatinine levels are currently used to assess renal function, but this method has some important limitations, mainly because creatinine is filtered by the glomerulus and is secreted by the proximal tubules, and the level of serum creatinine depends on muscle mass and meat intake. Furthermore, the level of serum creatinine increases only when renal failure is in an advanced stage (1). GFR can also be measured by subcutaneous or intravenous administration of substances labeled with radioactive isotopes, such as wCx-inulin, which is considered a standard reference. However, these tests are too complex and laborious for routine clinical application (2). Cystatin C (CysC) is produced by nucleated human cells and its concentration does not change in systemic inflammatory processes. Glomerular filtration eliminates CysC from the bloodstream, and because CysC is a non-glycosylated low-molecular weight protein with an isoelectric point of approximately 9, it is freely filtered by the glomeruli. There is a strong correlation between high levels of CysC in serum and renal damage, so CysC has been suggested as an ideal endogenous marker to detect subclinical kidney disorders (3–7). High concentrations of this protein have also been associated with an increase in the incidence of tumors, neurological disorders, and conditions related to renal damage (8). However, information available on reference values for serum
The epidemiology of medically attended respiratory syncytial virus in older adults in the United States: A systematic review

Objective This review was undertaken to assess the historical evidence of the disease incidence and burden of laboratory-confirmed respiratory syncytial virus (RSV) in medically attended older adults. Design A qualitative systematic literature review was performed; no statistical synthesis of the data was planned, in anticipation of expected heterogeneity across studies in this population. Methods A literature search of PubMed, Embase, and the Cochrane Library was conducted for studies of medically attended RSV in older adults (≥ 50 years) published in the last 15 years. Two independent reviewers screened titles and abstracts based on predefined inclusion and exclusion criteria. Results From 10 studies reporting incidence proportions, RSV may be the causative agent in up to 12% of medically attended acute respiratory illness in older adults unselected for comorbidities, with variations in clinical setting and by year. In multiple studies, medically attended–RSV incidence among older adults not selected for having underlying health conditions increased with increasing age. Of prospectively followed lung transplant recipients, 16% tested positive for RSV. In hospitalized adults with chronic cardiopulmonary diseases, 8% to 13% were infected with RSV during winter seasons (8%-13%) or metapneumovirus season (8%). Hospitalizations for RSV in older adults typically lasted 3 to 6 days, with substantial proportions requiring intensive care unit admission and mechanical ventilation. Among older adults hospitalized with RSV, the mortality rate was 6% to 8%. Conclusions Protection of older adults against RSV could reduce respiratory-related burden, especially as age increases and the prevalence of comorbidities (especially cardiopulmonary comorbidities) grows.
The effect of smoking on clinical, laboratory, and radiographic status in rheumatoid arthritis.

OBJECTIVE (1) To determine the degree to which rheumatoid factor (RF) positivity is associated with smoking; (2) to determine the quantitative effect of smoking and smoking length on the concentration of RF in all patients, and, in the seropositive patients separately, determining if a "dose-response" effect exists; (3) to investigate these relationships in men and women to clarify whether the effect of smoking is similar in both sexes; (4) to determine the effect of smoking, controlling for RF, on a variety of measures of disease status, severity, and activity. METHODS Six hundred ten consecutive patients with rheumatoid arthritis seen for routine clinical care provided information on their smoking history. All underwent a complete joint examination, completed a series of health status questionnaires, provided information concerning pulmonary illnesses, underwent determinations for RF and erythrocyte sedimentation rate (ESR), and had hand radiographs. RESULTS RF concentration was linearly related to the number of years smoked. This association was present in both sexes, but was stronger in men. Smoking was similarly related to rheumatoid nodule formation. A nonlinear relationship was found between smoking and radiographic abnormalities as determined by the Larsen method, even controlling for RF. Similarly, pulmonary illness was independently related to smoking and RF. No effect of smoking was seen on disease process variables such as ESR, pain, joint count, global severity, or functional ability. CONCLUSION Quantitative relationships exist between smoking extent and RF positivity, RF concentration, nodule formation, radiographic progression, and pulmonary disease. These 3 latter effects are independent of RF positivity or concentration. Smoking does not contribute to alterations in disease activity measures, but appears to play a role in overall severity of disease.
herg1b Expression as a Potential Specific Marker in Pediatric Acute Myeloid Leukemia Patients with HERG 897K/K Genotype

Human ether-a-go-go related gene (herg) encoding HERG K+ channel has been demonstrated in many previous studies with its association to cell cycle progression and growth in tumor cells. The upregulated expression of HERG K+ channels was determined in different tumor types. Furthermore, not only full-length transcript herg1 but also a truncated isoform herg1b was shown to be expressed in cancer cells. In this study, the expression levels of herg1 and herg1b and the impact of K897T mutation on their expressions were investigated in pediatric acute myeloid leukemia (pAML). Expression levels of herg1 and herg1b isoforms were analyzed by quantitative real time polymerase chain reaction (PCR) in pAML patients together with healthy donors, and their expressions were confirmed by western blotting. The 2690 A>C nucleotide variation in KCNH2 gene corresponding to K897T amino acid change was analyzed by PCR followed by restriction enzyme digestion. herg1b overexpression was observed in tumor cells compared to healthy controls (P = .0024). However, herg1 expression was higher in healthy control cells than tumor cells (P = .001). The prevalence of polymorphic allele 897T was 26% in our patient group and 897T carriers showed increased herg1b expression compared to wild-type allele carriers. Our results demonstrate the presence of the increased levels of herg1b expression in pAML. In addition, we report for the first time that, pAML subgroup with HERG 897K/K genotype compared to 897K/T and T/T genotypes express increased levels of herg1b. In conclusion, HERG 897K/K genotype with increased level of herg1b expression might well be a prognostic marker for pAML.
Molecular cloning, expression and regulation analysis of the interleukin-6 (IL-6) gene in goose adipocytes

1. Interleukin-6 (IL-6) is a multifunctional cytokine involved in lipid metabolism in adipose tissue. The objective of the study was to identify and characterize the IL-6 gene in the goose. 2. A full-length coding sequence (CDS) of the goose (Anser anser) IL-6 gene was cloned that encoded a 234-amino acid peptide containing a 38-amino acid signal peptide, an IL-6/G-CSF/MGF family consensus pattern and four conserved α-helices. The mature goose IL-6 showed 74% and 39% identities to that of chicken and human, respectively. 3. Quantitative real-time PCR analysis showed that the goose IL-6 was predominantly expressed in liver and was up-regulated in adipocytes by lipopolysaccharide (LPS) and oleic acid.
Cervical lymph node metastasis in oral squamous cell carcinoma: a correlative study between histopathological malignancy grading and lymph node metastasis.

BACKGROUND Histologic grading has been used as a prognostic factor and for clinical behavior evaluation of oral squamous cell carcinoma for the past several decades. At the same time, the prognostic value of different grading classifications remains controversial. A major problem for most histopathological grading systems is the intraobserver and interobserver disagreement. AIMS AND OBJECTIVES To validate the prognostic efficiency of the histologic assessment of the primary tumor in predicting cervical metastasis, to identify those histologic features in the tumor most closely associated with cervical metastasis and to evaluate the reliability of the multifactorial grading (MFG) system by measuring intraobserver and interobserver agreement using kappa statistic. MATERIALS AND METHODS A set of 60 cases were chosen at random out of the 292 squamous cell carcinoma cases reported in our institution from 2007 to 2010. All cases were graded according to: Modified Broders' descriptive system and Anneroth et al., MFG system. Two Pathologists independently graded the tumor forefront blinded to the node metastasis. RESULTS The MFG showed a significant relation between the degree of histologic malignancy and presence of metastasis in the nodes. Among the components of grading, a significant difference was observed in the nuclear polymorphism and the pattern of invasion between the metastatic and non-metastatic patients. Intraobserver and interobserver agreement was acceptable and satisfactory. CONCLUSIONS Moderate to good agreement between observers greatly increases the validity of the MFG system. The multifactorial malignancy grading could serve as a predictor for metastasis in the cervical lymph nodes.
Limb-shaking TIA: Cortical myoclonus associated with ICA stenosis

Limb-shaking associated with steno-occlusion of the internal carotid artery (ICA) was first reported by Miller Fisher1 in 1962, and is characterized by brief, jerky, coarse, involuntary movements involving an arm or leg. Limb-shaking TIA is an under-recognized manifestation of an intracranial and extracranial carotid occlusion or severe stenosis. Although hemodynamic compromise has been suggested to be associated with shaking movements, the pathogenic nature of this symptom remains unclear. Neurophysiologic evaluation of this movement disorder would be useful, but the attack is rare and typically lasts less than 5 minutes.2 Thus, few reports have investigated this hyperkinetic phenomenon under neurophysiologic assessment.3
Psychophysiologic Predictors of Weaning from Mechanical Ventilation in Chronic Bronchitis and Emphysema

Tis study identified psychophysiologic variables related to successful weaning in 27 ventilator-dependent patients with chronic bronchitis and emphysema (CBE) from two long-term care pulmonary-specialty hospitals in South Central Florida Subjects were studied from admission until weaning occurred (successful weaning without mechanical ventilation) or until they were transferred without being weaned or died (unsuccessful weaning). The study subjects, 15 males and 12 females, ranged in age from 56 to 89. Baseline data on the variables (age, mastery, hope, social support, dyspnea, and rapid shallow breathing index [RSBI]) were not statistically significant by gender. he logistic regression model identified mastery and RSBI to be the best predictors of successful weaning (model X2 = 16.33, df = 2, and p value = .0003; prediction rate 82%).
On the appropriate use and interpretation of animal models in transfusion medicine research

E xperimental scientific exploration has classically made extensive use of simplified models and specific laboratory conditions to allow for controlled explorations of the natural world. Transfusion medicine research is no different in this regard, and ongoing generation of knowledge has required simplified models to investigate the complex clinical situations and effects seen in patient care. The Faustian bargain of model systems is that, as one uses progressively simplified and controlled systems, one simultaneously drifts further from the natural processes being modeled. In recent years, substantial progress has been made regarding the introduction of new animal systems and tools to study transfusion biology. However, this direction raises several serious questions; in particular, to what extent do these models need to reflect known human biology to remain useful? This review examines the issues of how best to apply animal models to transfusion medicine research, how to progress from animal results to hypotheses about human biology, how to integrate animal results with human data, and how to avoid the ever present pitfalls of premature rejection of useful models or overinterpretation of results from potentially irrelevant systems.
Comparison of retinal nerve fibre layer measurements from time domain and spectral domain optical coherence tomography systems.

OBJECTIVE To compare retinal nerve fibre layer (RNFL) thickness measurements acquired using spectral domain (SD) and time domain (TD) optical coherence tomography (OCT) systems. STUDY DESIGN Prospective clinical study. PARTICIPANTS Twenty eyes of 20 healthy volunteers. METHODS All patients underwent 3 sets of circular OCT scans around the optic disc using both a TD OCT system, and a new SD OCT system. RNFL thickness measures within each of 4 quadrants, as well as overall mean RNFL thickness, were compared. Bland-Altman plots were also used to assess agreement. RESULTS Using the RTVue-100, RNFL measurements in the superior quadrant were, on average, 20 microm greater than those obtained from the Stratus (151.8 microm vs 131.7 microm, p< 0.0001). RNFL measures within other quadrants and overall mean RNFL thickness were not significantly different between systems. Bland-Altman plots indicated large differences between Stratus and RTVue-100 for all variables, with 95% limits of agreement spanning clinically important ranges of >50 microm for all RNFL variables. CONCLUSIONS Significant differences exist between RNFL measurements obtained from the TD and SD OCT systems used in this study. These related, but distinct, technologies are not interchangeable. Further studies will be required to allow for appropriate clinical use of new SD OCT systems.
Reliable Estimates of Plasma Protein S Levels: Are We Getting any Closer?

Of all the inherited thrombophilic defects, protein S (PS) deficiency carries the most uncertainty in its association with thromboembolic events. Family studies of large and multiple pedigrees in whom a genetic defect in the PS alpha gene was identified suggest that genetic defects of PS are indeed a risk factor (1-2). Case-control studies based on PS-deficiency phenotypes, on the other hand, have provided contrasting results, ranging from no associated risk to a mild-moderate risk association (3-7). Even taking into account the overestimation of risk that family studies afford, these contrasting results are difficult to reconcile.
EXTENDED BIC FOR SMALL-n-LARGE-P SPARSE GLM

The small-n-large-P situation has become common in genetics research, medical studies, risk management, and other fields. Feature selection is crucial in these studies yet poses a serious challenge. The traditional criteria such as AIC, BIC, and cross-validation choose too many features. In this paper, we examine the variable selection problem under the generalized linear models. We study the approach where a prior takes specific account of the small-n-large-P situation. The criterion is shown to be variable selection consistent under generalized linear models. We also report simulation results and a data analysis to illustrate the effectiveness of EBIC for feature selection. In many scientific investigations, researchers explore the relationship between a response variable and some explanatory features through a random sample. Ex- amples of such features include disease genes and quantitative trait loci in the human genome, biomarkers responsible for disease pathways, and stocks gener- ating profits in investment portfolios. The selection of causal features is a crucial aspect in this. When the sample size n is relatively small but the number of features P under consideration is extremely large, there is a serious challenge to the selection of causal features. Feature selection in the sense of identifying causal features is different from, but often interwoven with, model selection; the latter involves two operational components: a procedure for selecting candidate models, and a criterion for assessing the candidate models. In this article, we concentrate on the issue of model selection criteria. Traditional model selection criteria such as Akaike's information criterion (AIC) (Akaike (1973)), cross-validation (CV) (Stone (1974)) and generalized cross-validation (GCV) (Craven and Wahba (1979)) essentially address the pre- diction accuracy of selected models. The popular Bayes information criterion (BIC) (Schwarz (1978)) was developed from the Bayesian paradigm in a differ- ent vein. BIC approximates the posterior model probability when the prior is
Regulation of antibody response in different immunoglobulin classes. III. In vitro demonstration of "IgE class-specific" suppressor functions of DNP-mycobacterium-primed T cells and the soluble factor released from these cells.

Selective suppression of anti-DNP IgE antibody response by DNP-Tbc-primed T cells was studied by using the in vitro culture system of murine spleen cells. The addition of DNP-Tbc-primed cells to DNP-OA-primed cells suppressed the in vitro production of anti-DNP IgE antibody response induced with DNP-OA without any effect on anti-DNP IgG antibody response. The addition of DNP-MGG-, DNP-KLH-, or DNP-Asc-primed cells to DNP-OA-primed cells did not show any suppressive effect on anti-DNP IgE antibody response. Depletion of T cells by anti-ϑ treatment abolished the suppressor activity of DNP-Tbc-primed cells, whereas depletion of B cells by anti-Ig-column did not affect the suppressor activity. The suppressor activity of DNP-Tbc-primed cells was dose-dependent and radiosensitive. Cell-free supernatants (CFS) from the culture of DNP-Tbc-primed cells with DNP-HSA-pulsed macrophages or DNP-HSA-coupled Sepharose beads showed the suppressor activity on anti-DNP IgE antibody response of DNP-OA-primed cells. CFS did not show any effect on IgG response. The suppressor activity of CFS was not absorbed with DNP-HSA- or anti-Ig-coupled Sepharose immunoadsorbent, indicating that the IgE class-specific suppressor factor is not antigen-specific and does not have Ig-determinants.
Assessment of hemodialysis effect on left ventricular mechanical dyssynchrony by tissue synchronization imaging

Background: Abnormal myocardial loading can contribute to left ventricular (LV) mechanical dyssynchrony in patients with end-stage renal disease (ESRD) and may be a factor contributing to the high incidence of cardiac deaths in these patients. The study aims to evaluate the possible presence of LV dyssynchrony in ESRD patients, and acute effect of hemodialysis (HD) on LV synchronicity using tissue synchronization imaging (TSI). Methods: Twenty patients with ESRD (11 males and 9 females) with mean age 63.1±4.41 were underwent echocardiographic examination before and immediately after a single HD session. Echocardiography was done using two dimensional strain imaging, global longitudinal systolic strain was measured in the apical views. LV mechanical dyssynchrony was assessed using TSI analysis enabling the retrieval of regional intraventricular systolic delay data. LV mechanical dyssynchrony was defined as a maximum regional difference in time to peak systolic velocity >105 ms and/or all segments standard deviation (SD) “dyssynchrony index” >32.6 ms. Results: All patients had dyssynchronous LV segments before HD. A single HD session induced decrease in the global LV systolic strain from -19.65 ± 3.03 to -16.29 ± 2.75 (P<0.001), it also reduced the all segments maximum difference from 123.65 ± 33.94 to 102.60 ± 20.84 (P<0.001), the all segments SD was also reduced from 52.2 ± 12.31 to 40.15 ± 8.51 (P<0.001). Furthermore, the systolic dyssynchrony parameters were positively related to the LVEDD. Conclusion: LV dyssynchrony is frequently present in patients with ESRD. The severity of LV dyssynchrony decreases after a single session of HD suggesting the deleterious effect of volume overload and may be the accumulating toxins on LV myocardium in such patients. Correspondence to: Waleed Abdou Ibrahim Hamed, Assistant Professor of Cardiology, Department of Cardiology, Menofiya University, Egypt, Tel: 002/01003618195, Fax: 002/048/2235679, E-mail: waleedabdou@yahoo.com