Miracle-dz/UniFAR-FTUs huggingface dataset:
Morphological Correlates of KIT and PDGFRA Genotypes in Gastrointestinal Stromal Tumour

Objective: The aim of the study was to study the clinicopathological and immunohistochemical features of gastrointestinal stromal tumours and correlation with KIT/PDGFRA mutations. Material and Method: Eighty consecutive resected cases were genotyped for KIT exons 11, 9, 13, 17 and PDGFRA exons 18, 14, 12 and correlated with histomorphology by nonparametric tests. Results: Forty-seven cases (58.8%) were in the high-risk group. Males had higher rates of KIT exon 11 and PDGFRA exon 18 mutations than females (p=0.03). KIT and PDGFRA mutation frequencies were lower (58.8%) than western data showing KIT exon 11 mutation in 63.8%, KIT exon 9 mutation in 19% and PDGFRA exon 18 mutation in 17% of the cases. Extragastrointestinal stromal tumours (n=6) showed 100% mutation. KIT exon 11 deletion was associated with gastric location (60%) (p=0.04), spindle cells (63.3%), and high-risk stratification (66.6%) (p=0.01) while KIT exon 9 mutation was common in small intestine (66.7%) (p=0.04), in higher risk groups (66.7%) (p=0.01) and 75% of codon 502-503 duplications (p=0.03). PDGFRA 18 mutation was common in males (p=0.03), in gastric location (62.5%) (p=0.04), in cases showing mild to moderate atypia (62.5%) (p=0.01) and lower risk stratification (62.5%) (p=0.01). KIT/PDGFRA mutations were significantly associated with gender (p=0.03), location (p=0.04), nuclear atypia (p=0.01) and risk stratification (p=0.01). Conclusion: Morphological features and anatomic location may be useful in deciding molecular testing strategy, particularly in resource-limited settings, when a plethora of targetable mutations are present. An algorithm may be derived for genotyping with KIT exon 11 and PDGFRA exon 18 heading the list of targetable mutations. This approach may reduce financial burden on patients as well as workload on hospital staff.
POLICE AND HOSPITAL RECORDING OF NON-FATAL ROAD ACCIDENT CASUALTIES: A STUDY IN GREATER MANCHESTER

A study of injuries recorded by police and hospitals was carried out in the course of research on the cost of road accident injuries. Casualty records for road accident patients treated at three hospitals in the Greater Manchester area over a six month period were collected and matched with police road accident records. The data were analysed to identify the incidence of different types of injury and the distribution of injury severity, and to estimate the extent to which police records under-report casualties or mis-classify the severity of their injuries. The report summarises the results, comparing the data recorded by the hospital with that recorded by the police for the national accident statistics. Reasons for the differences between the two sources of information are discussed, and the implications of the results for accident statistics are presented. (a)
Intravenous stem cell dose and changes in quantitative lung fibrosis and DLCO in the AETHER trial: a pilot study.

OBJECTIVE Our purpose was to compare quantitative CT-derived changes in lung fibrosis with pulmonary function, including DLCO, in human subjects with idiopathic pulmonary fibrosis who received an injection of one of two different intravenous doses of human bone-marrow-derived mesenchymal stem cells. PATIENTS AND METHODS Two three-subject cohorts from the AETHER trial (Allogeneic Human Cells in subjects with Idiopathic Pulmonary Fibrosis via Intravenous Delivery) underwent high-resolution CT and clinical testing at baseline, 24 weeks, and 48 weeks after injection. Cohort 1 received 2x107 stem cells, and cohort 2 received 1x108 stem cells. CT scans were quantitatively analyzed for lung fibrosis using 510K cleared validated software. The percent predicted DLCO and other pulmonary function studies were obtained. RESULTS The cohorts were well matched in lung fibrosis at baseline as assessed by CT scan and lung function. The mean QLF in cohort 1 increased from 13.1% at baseline to 17.1% at 48 weeks, while mean QLF in cohort 2 increased from 15.4% at baseline to 16.5% at 48 weeks. The subjects in cohort 2 progressed more slowly in whole lung fibrosis by a mean of 2.87% compared with cohort 1 (p=0.001 with adjustment of baseline covariates) during the baseline to the 48-week interval. The baseline DLCO was lower in cohort 2 than in cohort 1 (p<0.0001). Over 48 weeks of the study, cohort 2 subjects demonstrated a mean DLCO decline of only 2% compared with a decline of 17% in cohort 1 subjects (p=0.02). CONCLUSIONS In this pilot study, the subjects receiving 1x108 stem cells demonstrated slower progression in quantitative lung fibrosis and a smaller decrease in DLCO than subjects receiving 2x107 stem cells.
Specific distribution of expression and enzymatic activity of cholesterol biosynthetic enzyme DHCR24 orthologs in the phytophagous insect

ABSTRACT Insects must intake sterol compounds because of their inability to synthesize cholesterol de novo. In phytophagous insects, enzymatic conversion of phytosterols to cholesterol involving 24-dehydrocholesterol reductase (DHCR24) exerts to acquire cholesterol. Here, we reported the presence of two DHCR24 homologs in the silkworm Bombyx mori, BmDHCR24-1 and -2, with several transcript variants. Consistent with the data of spatial expression analyses by RT-PCR, predominant enzymatic activity of DHCR24 was observed in B. mori larval midgut whereas weak activity was observed in the other tissues examined. In addition, BmDHCR24-1 expression in HEK293 cells showed an enzymatic activity, but BmDHCR24-2 did not, although both BmDHCR24s were localized in the endoplasmic reticulum, where the mammalian DHCR24s are located to exert their enzymatic activities. The present data indicated that BmDHCR24-1 but not BmDHCR24-2 contributes to conversion of phytosterols to cholesterol mainly in the midgut of the phytophagous lepidopteran larvae. Graphical abstract DHCR24 (24-dehydrocholesterol reductase) involved in conversion of phytosterols into cholesterol functions predominantly in the midgut of silkworm.
Efficacy of Primary Stent-Graft Placement in the Treatment of Vascular Access Graft Outflow Tract Stenosis

Purpose: The aim of this study is to present our personal experience using covered nitinol stent-graft in the treatment of outflow tract stenosis of arteriovenous grafts (AVGs) for hemodialysis access. Materials and Methods: Between May 2015 and October 2017, we retrospectively evaluated 36 (24 males, 12 females; mean age: 65.6 years) patients with AVGs on hemodialysis who underwent percutaneous angioplasty followed by endovascular stent-graft deployment for the treatment of stenosis of the venous outflow of the AVG. Indication for treatment included early restenosis (<3 months after previous percutaneous transluminal angioplasty [PTA]), long stenosis (stenoses >50% extending for a length >5 cm), and recoil of the stenosis after PTA performed with a noncompliant high-pressure balloon. Of 36 patients, 27 (75%) required surgical thrombectomy prior to endovascular procedure. Technical success, clinical success, primary and secondary patency, and safety were evaluated. Results: Technical success was 100%, and clinical success was 94.4%. Primary patency was 94.4%, 72.2%, 63%, 45.9%, and 45.9% at 1, 3, 6, 12, and 18 months (average: 215 days, range: 9-653 days); secondary patency was 94.4% and 86.1% at 1 and 3 months; 80.4% at 6, 12, and 18 months; and 53.6% at 24 months (average: 276.8 days, range: 9-744 days). No deaths were registered. Conclusions: In selected cases, the use of stent-graft represents an effective and safe solution for the treatment of stenotic complications of the venous outflow of AVGs, even in the setting of access thrombosis.
Battey’s operation as a treatment for hysteria: a review of a series of cases in the nineteenth century

Ovarian resection as a treatment for hysteria, called ‘Battey’s operation’ or ‘normal ovariotomy’, was performed in the nineteenth century. Battey later reported that the resected ovaries appeared to have ‘cystic degeneration’. Currently, patients with acute neuropsychiatric symptoms are screened for teratomas for the differential diagnosis of anti-NMDA receptor encephalitis. There is now a hypothesis that ovarian lesions resulting in paraneoplastic encephalitis were among the patients who underwent Battey’s operation. We identified 94 published cases of Battey’s operation for neuropsychiatric symptoms in the late nineteenth century. Among 36 cases with detailed descriptions, we found 3 patients who showed acute onset neuropsychiatric symptoms with macropathological ovarian findings that were compatible with teratoma. They showed favourable prognoses after surgery and might have motivated the surgeons to perform the operation.
A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks

Background In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition. Methods We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks. Results In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity. Conclusion Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.
How does the duration of consults vary for upper respiratory tract infections in general practice where an antibiotic has been prescribed?

BACKGROUND There is limited data on the duration of consults resulting in the prescription of antibiotics for upper respiratory tract infections (URTIs) in general practice. OBJECTIVE To explore how demographic factors influence consult duration where antibiotics have been prescribed for URTI in Australian general practice. METHODS 2985 URTI-specific presentations were identified from a national study of patients who were prescribed an antibiotic after presenting to general practice between June and September 2017. Consult duration was analysed to assess for any variation in visit length based on demographic factors. RESULTS The overall median consult duration was 11.42 minutes [interquartile range (IQR) 7.95]. Longer consult duration was associated with areas of highest socio-economic advantage where patients living in postcodes of Index of Relative Socio-economic Advantage and Disadvantage (IRSAD) Quintile 5 (highest 20% on the IRSAD) had significantly longer consults [median 13.12 (IQR 8.01)] than all other quintiles (P < 0.001). Females [11.75 (IQR 8.13)] had significantly longer consults than males [10.87 (IQR 7.57); P < 0.001]. Clinics based in State C and State F had significantly shorter consults when compared with all other included states and territories (P < 0.001) and shorter consult duration was associated with visits on Sundays [median 8.18 (IQR 5.04)]. CONCLUSION There is evidence for the association of demographic and temporal factors with the duration of consultations for URTIs where an antibiotic has been prescribed. These factors warrant further research.
Psychiatric disorders and young adult milestones in HIV-exposed, uninfected youth

ABSTRACT The global population of perinatally HIV-exposed but uninfected (HEU) children is growing, with relatively little known about their psychosocial outcomes, particularly across adolescence and young adulthood. Using data from a longitudinal cohort study of HEU youth in New York City (N = 134), we examine rates of substance use disorders (SUD) and non-SUD psychiatric disorders (mood, anxiety, and behavioral) at five time-points during adolescence and young adulthood, as well as associated demographic and environmental factors and the association of ever having a disorder with young adult developmental milestones. HEU participants in this study experienced high rates of psychiatric disorders, particularly SUD in young adulthood. During the entire study period (2003–2018), over one third were diagnosed at least once with a SUD, and 69% were diagnosed with a non-SUD psychiatric disorder. Older age and female gender were associated with higher rates of non-SUD diagnoses. A history of meeting criteria for any disorder at any time point was associated with reduced odds in young adulthood of working or being in school and increased odds of reporting incarceration, homelessness, and recent condomless sex. There is an urgent need to develop systems to follow HEU youth and provide services to intervene and treat psychiatric disorders, including substance use.
The Recurring Natural Disaster and its Influence on the Mental Health of the Older Adult

The Eruption of Miyake Island’s Volcano, Oyama, in 2000 When a disaster comes unexpectedly, the disaster survivors not only have to adopt a sudden change of daily environment but they also have to face the challenge of reconstructing their lives. People experience changes or overcome difficulties more or less on a daily basis, and there is usually enough time for them to adapt to their new environment or reconstruct their lives. However, the demands on survivors at the time of a disaster are much more severe and urgent. The eruption of Oyama, Miyake Island on June 26, 2000 was different from its usual time-limited eruption and subsequent lava flows. Instead, the eruption in 2000 blew a large portion of the summit and started a continuous emission of poisonous volcanic gas. This volcanic activity has lingered long term making the eruption of Oyama in 2000 unprecedented in the worldʼs recorded seismic history. The eruption and subsequent ashes, mudslides, earthquakes, and ongoing emission of volcanic gas forced the residents of the island to take refuge from their home island for four years and five months. Despite strong economic and spiritual connections to the nature of the island, Miyake Islandʼs residents took repeated refuge from the 2000 eruption and ongoing volcanic gas. Their extended life as refugees became hard and severe, especially for older adults. Their experiences of the 2000 eruption became wholly different from prior eruptions, and ultimately changed each survivorʼs perspectives on life and nature. During their time of refuge, “Disaster Relief Act” and “Victims Assistant Act for Rebuilding a Life” were instituted and financial aid was given to the refugees. However, many of them still suffered financially. Older adults without an income had no choice but to use their pensions and savings to survive. Living situations during their exile affected the older adultsʼ mental health immensely. Displacement from their homelands meant the deterioration of their lifelong communities, and “80% of refugees over 50 years old developed some kind of health problems” (Mitani, 2001). Despite these circumstances, many older adults encouraged themselves and survived those days of hardships by saying, “we will get back to the island,” and “everything will be fine again once we return to the island. ” In February 2005, after long and desperate years as refugees, the islanders were allowed to return to the homelands. When the evacuation order was lifted, older adults so strongly wished to return to their island that they were willing to wear gas masks on a daily basis. On February 1, 2005, a ship returned 60 refugees from the bridge of Tokyo-Takeshiba to Miyake Island. Eight hundred and forty three families returned over the next three months. However, their joy in returning to their island The Recurring Natural Disaster and its Influence on the Mental Health of the Older Adult
The importance of real-life research in respiratory medicine: manifesto of the Respiratory Effectiveness Group

Randomised controlled trials (RCTs) are universally considered as the gold standard for evaluating the efficacy of treatments. Their main strength is that, through randomisation, they avoid any major imbalance between compared groups: therefore, observed outcome differences between groups at the end of the trial are most likely related to treatment effects. Since they are inherently prospective by design, they also permit stability throughout the study to ensure that all conditions remain optimal to test the hypothesis of interest. These include high-quality follow-up, reinforced adherence, etc. Consequently, these studies can reach the highest level of internal validity, provided that all quality standards are followed, such as those defined by CONSORT guidelines [1].
Treatment Outcome in Patients with Primary or Secondary Transformed Indolent B-Cell Lymphomas

Background: Histologic transformation (HT) of indolent B-cell lymphomas into an aggressive form can occur simultaneously (primary HT, pHT) or sequentially after a preceding diagnosis of indolent lymphoma (secondary HT, sHT). The clinical course after diagnosis of HT is variable. Objectives: To describe the outcome of treatment in pHT and sHT patients. Methods: We retrospectively analyzed HT cases with an underlying follicular lymphoma, nodal marginal zone lymphoma, extranodal marginal zone lymphoma, lymphoplasmacytic lymphoma, or small lymphocytic lymphoma at our institution. Kaplan-Meier estimates were used to calculate progression-free survival (PFS) and overall survival (OS). Results: Ninety-two HT patients were identified, 38 with pHT and 54 with sHT. In sHT, time-to-transformation was not influenced by the preceding treatment strategy of the indolent lymphoma component. In pHT, median PFS was 61 months (95% CI 27–61), and OS was not reached. In sHT, median PFS and OS was 14 months (95% CI 9–32) and 42 months (95% CI 16–90), respectively. Significant differences between pHT and sHT in PFS (p = 0.002; Hazard ratio [HR] 2.30, 95% CI 1.36–3.91) and OS (p = 0.0001; HR 3.30, 95% CI 1.81–6.03) were observed. Response to treatment for transformation was highly prognostic of PFS and OS (p < 0.0001). Conclusions: The outcome in pHT cases is favorable and significantly better than in sHT cases. Failure to achieve a remission after treatment for transformation confers a dismal prognosis.
Surveillance for Coccidioidomycosis — United States, 2011–2017

Problem/Condition Coccidioidomycosis (Valley fever) is an infection caused by the environmental fungus Coccidioides spp. , which typically causes respiratory illness but also can lead to disseminated disease. This fungus typically lives in soils in warm, arid regions, including the southwestern United States. Reporting Period 2011–2017. Description of System Coccidioidomycosis has been nationally notifiable since 1995 and is reportable in 26 states and the District of Columbia (DC), where laboratories and physicians notify local and state public health departments about possible coccidioidomycosis cases. Health department staff determine which cases qualify as confirmed cases according to the definition established by Council of State and Territorial Epidemiologists and voluntarily submit basic case information to CDC through the National Notifiable Diseases Surveillance System. Results During 2011–2017, a total of 95,371 coccidioidomycosis cases from 26 states and DC were reported to CDC. The number of cases decreased from 2011 (22,634 cases) to 2014 (8,232 cases) and subsequently increased to 14,364 cases in 2017; >95% of cases were reported from Arizona and California. Reported incidence in Arizona decreased from 261 per 100,000 persons in 2011 to 101 in 2017, whereas California incidence increased from 15.7 to 18.2, and other state incidence rates stayed relatively constant. Patient demographic characteristics were largely consistent with previous years, with an overall predominance among males and among adults aged >60 years in Arizona and adults aged 40–59 years in California. Interpretation Coccidioidomycosis remains an important national public health problem with a well-established geographic focus. The reasons for the changing trends in reported cases are unclear but might include environmental factors (e.g., temperature and precipitation), surveillance artifacts, land use changes, and changes in the population at risk for the infection. Public Health Action Health care providers should consider a diagnosis of coccidioidomycosis in patients who live or work in or have traveled to areas with known geographic risk for Coccidioides and be aware that those areas might be broader than previously recognized. Coccidioidomycosis surveillance provides important information about the epidemiology of the disease but is incomplete both in terms of geographic coverage and data availability. Expanding surveillance to additional states could help identify emerging areas that pose a risk for locally acquired infections. In Arizona and California, where most cases occur, collecting systematic enhanced data, such as more detailed patient characteristics and disease severity, could help clarify the reasons behind the recent changes in incidence and identify additional opportunities for focused prevention and educational efforts.
The State and Factors Associated with the Level of Physical Activity and Exercise in Adolescents

Purpose: The purpose of this study was to investigate the state and factors associated with level of physical activity and exercise in adolescents. Method: The subjects in this study included 528 adolescents registered at two junior high schools and two senior high schools in J City. The data were collected between October 20 and 30, 2006. Result: The study results showed that 23.8% of the adolescents engaged in vigorous activities for at least 20 minutes, three times a week, while 3.8% of the adolescents participated in moderate activities for at least 30 minutes, five times a week. The subjective level of health was determined to be points on a 5-point scale. The level of stress was points on a 4-point scale. The obesity index was points. Significant correlations were found between the subjective level of health and level of stress (r=-.201, p=.000), the subjective level of health and the obesity index (r=-.135, p=.004), and between the level of stress and the obesity index (r=.107, p=.024). Conclusion: These results showed that developing a health promotion program that includes an exercise program specific to gender and level of education, individualized strategies of stress control and optimal weight control is required.