Miracle-dz/UniFAR-FTUs huggingface dataset:
Rapid resolution of hidradenitis suppurativa after bariatric surgical intervention

We report the case of a 52‐year‐old man who underwent rapid improvement of long‐standing treatment‐refractory hidradenitis suppurativa (HS) following bariatric surgical intervention and subsequent dramatic weight loss. This morbidly obese man had previously shown little response to multiple treatment avenues, including an extended course of antibiotic therapy and treatment with acitretin. He had developed marked genital lymphoedema consequential to HS, which had further complicated his HS treatment. However, his disease regressed significantly within weeks of undergoing laparoscopic gastric sleeve surgery, and the HS activity has remained quiescent for over 1 year since the bariatric intervention. This supports the role for obesity in the pathophysiology of HS, and highlights the importance of adequately addressing lifestyle factors in the treatment of HS.
Can ultrafiltration occur with a hypo-osmolar solution in peritoneal dialysis?: The role for 'colloid' osmosis.

1. In peritoneal dialysis the removal of excess body water (ultrafiltration) is traditionally achieved by means of dialysis solution made hypertonic to plasma by the addition of an osmotic agent. In vitro, the osmotic flow may be directed against the osmolality gradient by using a hypo-osmolar solution, but this phenomenon has not previously been applied to clinical peritoneal dialysis. 2. The ultrafiltration performances of hypo-osmolar dialysis solutions containing a high-molecular-weight glucose polymer (weight average molecular weight 22,000), isolated by fractionation of hydrolysed corn starch, were compared with those of hypertonic glucose solutions over a 12 h exchange in 11 patients well established on continuous ambulatory peritoneal dialysis. 3. Five per cent (272 +/- 1.1 mosmol/kg) and 7.5% (277 +/- 2.0 mosmol/kg) glucose polymer solutions produced net ultrafiltration of 243 +/- 53 and 526 +/- 59 ml that were significantly greater than the ultrafiltration of -48 +/- 96 and 223 +/- 84 ml associated with 1.36% (339 +/- 1.9 mosmol/kg) and 2.27% (393 +/- 3.2 mosmol/kg) glucose solutions, respectively. The net ultrafiltration with 10% glucose polymer (284 +/- 2.0 mosmol/kg) and 3.86% glucose (482 +/- 1.6 mosmol/kg) solutions were similar (699 +/- 48 versus 708 +/- 82 ml). 4. The transperitoneal absorption of glucose polymer was substantially lower than that of glucose solutions as was the potential calorie load per millilitre of ultrafiltrate. 5. The addition of 0.35% glucose (molecular weight 180) to 7.5% glucose polymer solution raised the dialysate osmolality to an iso-osmolar level (299 +/- 0.8 mosmol/kg) and produced ultrafiltration which was 29% greater than with 7.5% glucose polymer solution alone. (ABSTRACT TRUNCATED AT 250 WORDS)
Osteoarthritis at the base of the thumb

#### Summary points Patients with osteoarthritis of the thumb carpometacarpal joint, or base of the thumb, commonly present to primary care practitioners and orthopaedic surgeons because of pain and disability. The prevalence of this condition increases with age and is greatest in postmenopausal women. There is broad agreement regarding the prevalence of base of the thumb osteoarthritis. The largest longitudinal cohort study found a 15% prevalence in adults in Finland,1 and a smaller British study of postmenopausal women found a prevalence of 33%. 2 This is likely to increase as populations age and people stay active for longer. Presentation and diagnosis may be delayed because patients try to adapt by adjusting their hand position, using splints, and adopting preferential hand use to limit disability. For most patients the primary treatment is non-operative and can be delivered effectively by primary care doctors, physiotherapists, and occupational therapists. Patients with symptoms that persist despite conservative treatment require referral to a specialist and possibly surgery.3 Various studies have looked at osteoarthritis at the base of the thumb, including large epidemiological and patient cohort studies; biomechanical research; and smaller …
Feto‐Maternal Concentrations of Diazepam and N‐Demethyldiazepam after Intra‐amniotic Diazepam Injection

Ten milligrams of diazepam were injected intra‐amniotically in 8 mothers prior to therapeutic abortion by hysterotomy. Duration of pregnancy varied between 12 and 19 weeks. The diazepam concentrations in the maternal plasma were comparable to those found after the same intramuscular diazepam dose to the mother. The concentration of diazepam in the amniotic fluid 12 to 18 hours after the injection was no longer significantly higher than in the maternal plasma. The concentrations of diazepam in the fetal plasma, liver and brain were comparable to the concentrations resulting from a 10 mg intramuscular diazepam dose to the mother about 2 hours before legal abortion. The feto‐maternal ratio of diazepam was of same magnitude as after the intramuscular application to the mother. The results indicate that the disappearance of diazepam from the amniotic fluid in this stage of pregnancy occurs extraplacentally, through the membranes into the uterine circulation. In the treatment of a fetus with drugs having properties similar to diazepam, intra‐amniotic administration is no better than intramuscular administration to the mother.
Trade Books’ Historical Representation of Anne Sullivan Macy, The Miracle Worker

State and national initiatives provide teachers opportunities for interdisciplinary units with increased significance of non-fiction in English Language Arts and decreased reliance on the textbook in history and social studies. In these three disciplines, beginning in elementary school, students are expected to scrutinize multiple trade books of the same event, era, or person to construct understandings. Trade books are a logical curricular link between these three curricula. The initiatives, however, do not prescribe specific curricular materials; teachers rely on their own discretion when selecting available trade books. Historical misrepresentations have been found to emerge within trade books to varying degrees, yet only a few empirical studies have been conducted. We empirically evaluated trade books centered on the Anne Sullivan Macy, Helen Keller’s teacher. Celebrated as the Miracle Worker, she remains a relatively obscure figure. As a child, Macy faced the desertion or death of every family member and struggled to overcome poverty and isolation. Macy’s story, thus, complements Keller’s in consequential ways. We report various historical misrepresentations within the trade books and provide ancillary primary sources for teachers interested in addressing the historical omissions.
Bismuth-Based Quadruple Therapy Using a Single Capsule of Bismuth Biskalcitrate, Metronidazole, and Tetracycline Given With Omeprazole Versus Omeprazole, Amoxicillin, and Clarithromycin for Eradication of Helicobacter pylori in Duodenal Ulcer Patients: A Prospective, Randomized, Multicenter, North A

OBJECTIVES:This multicenter, randomized, active-controlled trial assessed efficacy of bismuth-based quadruple therapy with omeprazole, bismuth biskalcitrate, metronidazole, and tetracycline (OBMT) using a single-triple capsule of BMT compared with triple therapy with omeprazole, amoxicillin, and clarithromycin (OAC) in treatment of patients with Helicobacter pylori infection and duodenal ulcers.METHODS:Patients with active duodenal ulcer or diagnosed within the past 5 yr and with infection documented by 13C-urea breath test plus histology or culture were randomly assigned to 10-day course of OBMT using a single-triple capsule containing bismuth biskalcitrate 140 mg, metronidazole 125 mg, and tetracycline 125 mg given as three capsules q.i. d. with omeprazole 20 mg b.i. d. , or a 10-day course of OAC, omeprazole 20 mg plus amoxicillin 1 g plus clarithromycin 500 mg, all b.i. d. Eradication was confirmed by two negative urea breath tests at >1 month and >2 months after therapy.RESULTS:One hundred thirty-eight patients received OBMT and 137 OAC. Modified intent-to-treat eradication rates were 87.7% for OBMT and 83.2% for OAC (95% CI = −3.9%–12.8%; p = 0.29). OBMT eradicated 91.7% metronidazole-sensitive and 80.4% metronidazole-resistant strains (p = 0.06). OAC eradicated 92.1% clarithromycin sensitive and 21.4% clarithromycin-resistant strains (p < 0.001). Adverse events occurred in 58.5% of OBMT patients and 59.0% of OAC patients.CONCLUSIONS:OBMT regimen using the single-triple capsule is as efficacious and well-tolerated as the widely used OAC regimen for H. pylori eradication. This OBMT therapy largely overcomes H. pylori metronidazole resistance, present in 40% of patients in this study.
Homologous Recombination in E3 Genes of Human Adenovirus Species D

ABSTRACT Genes within the E3 transcription unit of human adenoviruses modulate host immune responses to infection. A comprehensive genomics and bioinformatics analysis of the E3 transcription unit for 38 viruses within human adenovirus species D (HAdV-D) revealed distinct and surprising patterns of homologous recombination. Homologous recombination was identified in open reading frames for E3 CR1α, CR1β, and CR1γ, similar to that previously observed with genes encoding the three major structural capsid proteins, the penton base, hexon, and fiber.
Impacts of exotic invertebrates on New Zealand's indigenous species and ecosystems

Biological invasions have significantly affected New Zealand's native species and ecosystems. Most prominent are the effects of exotic mammals and plants, whereas few invertebrate invasions are known to have major effects on native ecosystems. Exceptions are the well-known cases of Vespula wasps in Nothofagus forest ecosystems and Eriococcus scale insects in Leptospermum shrublands. This limited impact is surprising because over 2000 exotic invertebrates have become established in New Zealand, among them many pests of exotic crop plants. The low impact of exotic invertebrates that invaded forests and other native ecosystems in New Zealand is in contrast to the situation in other parts of the world where many invertebrates have become important pests. We provide an overview of known invasions by exotic invertebrates in New Zealand, and explore in more detail several examples of invasive species, including herbivores, predators, parasitoids, decomposers and other groups in forests, grasslands, and other terrestrial ecosystems. Several hypotheses have been proposed to explain the comparative scarcity of such invasions that affect New Zealand's indigenous ecosystems. There is a common view that New Zealand's native species and ecosystems are inherently resistant to exotic invertebrate invaders, and there is some evidence to support this view. As a result of the high level of endemism in New Zealand's flora, many native plants are phylogenetically distant from the host plants of many plant-feeding invaders. This provides some protection. Less host-specific plant-feeding insects, generalist predators, parasitoids and decomposers are less affected by such constraints, and these groups are perhaps more represented among the successful invaders of natural ecosystems. However, the shortage of studies on invader impacts on native species and ecosystems, compared with studies on economically important crops and production ecosystems, means that an unbiased comparison is not possible at this time. Furthermore, many invaders go through extended lag phases where their impacts are not easily noticed until they become more abundant and create more damage. Likewise, indirect effects of invaders, through more complex interactions in food webs, as well as impacts on ecosystem functions such as decomposition and pollination, are more subtle and difficult to detect without careful study. There is clearly a need for more research to determine more accurately which exotic invertebrates are already present, what their direct and indirect impacts are, and what generalisations and predictions about threats to native species and ecosystems are possible.
Angles between A1 and A2 segments of the anterior cerebral artery visualized by three-dimensional computed tomographic angiography and association of anterior communicating artery aneurysms.

OBJECTIVE The angle of arteries at bifurcations, as well as the blood flow, are factors of hemodynamic stress on the apical region, where aneurysms often develop. Using images obtained with three-dimensional computed tomographic angiography, we sought to determine the angles between the A1 and A2 segments of the anterior cerebral artery of the anterior communicating artery (ACoA) complex associated with aneurysms. These angles cannot be detected by conventional cerebral angiography. METHODS The course of the anterior cerebral artery was studied using three-dimensional computed tomographic angiography in 42 consecutive patients with ACoA aneurysms. Twenty-one other subjects, randomly chosen from patients without aneurysms, served as controls. Bilateral A1-A2 angles of the contrast-opacified anterior cerebral artery were measured by three-dimensional computed tomographic angiography in patients with normoplastic A1 segments, and the relationship between the angle and the association of aneurysms was analyzed using cerebral angiography. RESULTS Of the 42 patients with ACoA aneurysms, 19 patients showed hypo- or aplastic A1 segments, as did only 2 of the 21 patients without ACoA aneurysms. The average A1-A2 angle was determined to be 116+/-24 degrees (mean+/-standard deviation) in 18 patients having ACoA complexes with normoplastic A1 segments with aneurysms; 17 patients without aneurysms had A1-A2 angles measuring 143+/-14 degrees (P < 0.0001). The A1-A2 angle associated with ACoA aneurysms was 103+/-20 degrees, which was much smaller than that of the non-aneurysm side in the former group (128+/-20 degrees) (P = 0.0036). CONCLUSION ACoA aneurysms are associated with the smaller A1-A2 angle junction of the ACoA complex, where higher hemodynamic stress may occur in patients with normoplastic A1 segments.
Estradiol-based postmenopausal hormone therapy and risk of cardiovascular and all-cause mortality

Objective:Data on the health benefits and risks of postmenopausal hormone therapy (HT) are derived mainly from the use of conjugated equine estrogens. Estradiol-based regimens may have a different risk-benefit profile. We evaluated the risk of death caused by coronary heart disease (CHD), stroke, or any disease among users of estradiol-based HT regimens in a nationwide study in Finland. Methods:A total of 489,105 women who used HT from 1994 to 2009 (3.3 million HT exposure years), as indicated in the nationwide reimbursement register and the national Cause of Death Register, were followed. A total of 28,734 HT users died during follow-up; among the deaths, 3,843 were caused by CHD and 2,464 were caused by stroke. Mortality risk in HT users with varying duration of exposure (⩽1 y, >1 to 3 y, >3 to 5 y, >5 to 10 y, or >10 y) was compared with that in an age-matched background population. Results:Risk of CHD death was significantly reduced by 18% to 54% in HT users and was positively related to HT exposure time. Risk of stroke death was also reduced by 18% to 39%, but this reduction was not clearly related to HT exposure time. Risk of all-cause mortality was reduced in HT users by 12% to 38%, almost in linear relationship with duration of exposure. All these risk reductions were comparable in women initiating HT before age 60 years and women initiating HT at age 60 years or older. Conclusions:In absolute terms, the risk reductions mean 19 fewer CHD deaths and 7 fewer stroke deaths per 1,000 women using any HT for at least 10 years.
A fast learning algorithm for training feedforward neural networks

This paper deals with a fast and computationally simple Successive Over-relaxation Resilient Backpropagation (SORRPROP) learning algorithm which has been developed by modifying the Resilient Backpropagation (RPROP) algorithm. It uses latest computed values of weights between the hidden and output layers to update remaining weights. The modification does not add any extra computation in RPROP algorithm and maintains its computational simplicity. Classification and regression simulations examples have been used to compare the performance. From the test results for the examples undertaken it is concluded that SORRPROP has small convergence times and better performance in comparison to other first-order learning algorithms.
[Protective effect of continuous veno-venous hemofiltration on tissue and organ damage in patients with severe acute pancreatitis].

OBJECTIVE To explore the protective effect of continuous veno-venous hemofiltration (CVVH) on tissue and organ damage induced by severe acute pancreatitis (SAP). METHODS Thirty-seven SAP patients were randomly divided into CVVH group (n=22) and control group (n=15). Patients in control group were treated with conventional therapy, while patients in CVVH group were treated with conventional therapy combined with CVVH. Serum amylase (AMS) and lipase (Lip), the plasma levels of endotoxin, tumor necrosis factor-alpha (TNF-alpha), interleukin-1beta (IL-1beta), and C-reactive protein (CRP), and faecal occult blood test and blood serum leukocyte were determined. Functions of brain, kidney, liver, heart and lung were observed. RESULTS The treatment effect was better in CVVH group than that in normal group. The mortality rate was lower and the number of hospitalization day was decreased in CVVH group than those in normal group, they were 18.2 percent vs. 33.3 percent and (18.3+/-5.7) days vs. (27.5+/-8.6) days. CONCLUSION CVVH has a significant protective effect against tissue and organ damage induced by SAP.
Evaluation of clinical significance of endoglin expression during breast cancer and its correlation with ER and PCNA.

OBJECTIVE The present study is aimed to investigate the expression of Endoglin during breast cancer. Moreover, its clinical pathological significance, as well as correlation with estrogen receptor (ER) and proliferating cell nuclear antigen (PCNA), were also studied. PATIENTS AND METHODS qRT-PCR and Western blot assays were utilized to study PCNA mRNA, ER, Endoglin and protein expression. Immunohistochemistry analysis was conducted to determine the expression of Endoglin, ER, and PCNA protein in breast cancer tissue and adjacent cancer tissue. The microvascular density (MVD) was indicated by expression of Endoglin protein. The positive cell rate was used to express the protein expression level of ER and PCNA. RESULTS The mRNA expression levels of Endoglin, ER, and PCNA were significantly elevated in breast cancer tumor tissues in comparison with the cancer-adjacent tissues. The positive expression rates of Endoglin, ER, and PCNA were 69%, 56%, and 73% respectively in breast cancer tumor tissues. Endoglin MVD values in breast cancer tissues and cancer-adjacent tissues were (35.18 ± 9.57)/mm2 and (7.21 ± 1.63)/mm2, respectively. The expression of Endoglin protein in breast tumor tissues was positively correlated to lymph node metastasis and TNM stages, but it was not to menopause and tumor size. Endoglin protein was positively correlated to the expression of PCNA protein, but was not correlated to ER expression. CONCLUSIONS Endoglin protein expression is positively correlated to PCNA protein expression. So, Endoglin MVD in breast cancer tissues has important clinical significance in the assessment of breast cancer prognosis.
Biomechanical Comparison of Anatomic Single- and Double-Bundle Anterior Cruciate Ligament Reconstructions

Background: Arthroscopic identification of the anteromedial (AM) and posterolateral (PL) bundle locations of the anterior cruciate ligament (ACL) has facilitated an improved quantitative description of ACL anatomy. Few studies have directly compared the biomechanical laxity of anatomic single-bundle (SB) versus anatomic double-bundle (DB) ACL reconstruction techniques based on precise anatomic descriptions. Hypothesis: Anatomic tunnel positioning for SB and DB reconstructions would produce comparable anterior-posterior and rotatory knee laxity. Study Design: Controlled laboratory study. Methods: Nine matched pairs of cadaveric knees were evaluated for the kinematics of intact, ACL-deficient, and either anatomic SB or anatomic DB ACL-reconstructed knees. Reconstruction tunnels were placed either centrally in the ACL footprint or within the AM and PL footprints. A 6 degrees of freedom robotic system was used to assess knee laxity with an 88-N anterior tibial load and a simulated pivot-shift test of combined 10-N·m valgus and 5-N·m internal tibial torques. Rotational motion was measured with internal and external torques of 5 N·m along with varus and valgus torques of 10 N·m. One-sample and 2-sample independent t tests were used to compare between groups (P < .05). Results: No significant differences were found between anatomic SB and DB reconstruction groups during anterior tibial loading. Anterior tibial translations during simulated pivot shift had no significant differences between anatomic reconstruction groups. Tibial rotation for internal/external and varus/valgus torques showed no significant differences between anatomic reconstructions, with the exception of small (<3°) but statistically significant differences in internal rotation at 20° and 30° of flexion. Despite the similar behavior between the 2 anatomic reconstruction groups, neither technique was able to reproduce the intact state during an anterior tibial load. Conclusion: No significant differences in anterior translation were found between the anatomic SB and anatomic DB ACL reconstructions for simulated pivot shift or anterior tibial loading. Clinical Relevance: Although significant differences between reconstructions were observed for internal rotation, the small magnitude of these differences (<3°) may not have clinical significance.
Applying spatiotemporal models to study risk of smear-positive tuberculosis in Iran, 2001-2012.

SETTING Assessing tuberculosis (TB) distribution in regions over time is essential for health officials to have a proper understanding of current status, determine high-risk areas, and improve case management and resource allocation. OBJECTIVE To evaluate spatial distribution and trends in the risk of smear-positive Mycobacterium tuberculosis in Iran during 2001-2012 using spatiotemporal models. DESIGN Overall and province-specific trends in TB risk were estimated using a Bayesian spatiotemporal model. We obtained Bayesian posterior probabilities to test the hypothesis of the relative risk (RR) being equal to 1 and the significance of TB trends in each province. RESULTS Estimated countrywide trends declined at a rate of almost 3% per decade. The RR was the highest in the provinces of Sistan and Baluchestan, followed by Golestan, Khorasan-Razavi, Hormozgan, Qom, Guilan and South Khorasan. Upward temporal trends were observed in nine provinces. CONCLUSION TB risk was generally high in provinces bordering high TB burden countries; population movements from high-risk provinces and adjacent countries appear to be the main challenge to TB control. Nevertheless, the declining risk pattern in these provinces indicates good, but inadequate, progress with TB control. Different health policies according to TB risk and trend are required for each province.