Miracle-dz/UniFAR-FTUs huggingface dataset:
Economic evaluation of hormonal therapies for postmenopausal women with estrogen receptor-positive early breast cancer in Canada.

BACKGROUND Aromatase inhibitor (ai) therapy has been subjected to numerous cost-effectiveness analyses. However, with most ais having reached the end of patent protection and with maturation of the clinical trials data, a re-analysis of ai cost-effectiveness and a consideration of ai use as part of sequential therapy is desirable. Our objective was to assess the cost-effectiveness of the 5-year upfront and sequential tamoxifen (tam) and ai hormonal strategies currently used for treating patients with estrogen receptor (er)-positive early breast cancer. METHODS The cost-effectiveness analysis used a Markov model that took a Canadian health system perspective with a lifetime time horizon. The base case involved 65-year-old women with er-positive early breast cancer. Probabilistic sensitivity analyses were used to incorporate parameter uncertainties. An expected-value-of-perfect-information test was performed to identify future research directions. Outcomes were quality-adjusted life-years (qalys) and costs. RESULTS The sequential tam-ai strategy was less costly than the other strategies, but less effective than upfront ai and more effective than upfront tam. Upfront ai was more effective and less costly than upfront tam because of less breast cancer recurrence and differences in adverse events. In an exploratory analysis that included a sequential ai-tam strategy, ai-tam dominated based on small numerical differences unlikely to be clinically significant; that strategy was thus not used in the base-case analysis. CONCLUSIONS In postmenopausal women with er-positive early breast cancer, strategies using ais appear to provide more benefit than strategies using tam alone. Among the ai-containing strategies, sequential strategies using tam and an ai appear to provide benefits similar to those provided by upfront ai, but at a lower cost.
Action of mitomycin C on eosinophilic nasal polyposis

Objective: To evaluate the action of mitomycin C (MMC) on the in vitro synthesis of interleukin-5 (IL-5) and granulocyte-macrophage colony stimulating factor (GM-CSF) and the apoptotic index (AI) of eosinophils in eosinophilic nasal polyposis. Materials and methods:This experimental study was conducted on cultures of eosinophilic nasal polyp fragments from 22 patients. Two groups of fragments were constituted: samples not treated with MMC and used as controls, and samples treated with 400 µg/mL MMC for five minutes. The supernatant of the two groups was collected at 0, 12 and 24 hours for ELISA assay of IL-5 and GM-CSF. The AI was evaluated histologically after haematoxylineosin staining. Results:GM-CSF levels decreased in the MMC group after 24 hours (P≤0.05), but no significant modification of IL-5 secretion was observed in the group treated with MMC for 24 hours. The AI was increased in the group treated with MMC for 12 hours (P<0.001). Conclusion:MMC appears to decrease the production of GM-CSF and induces apoptosis of eosinophils.
Hemolysis and Hemolytic Uremic Syndrome following Five-fold N-Acetylcysteine Overdose

Context. Intravenous acetylcysteine (Acetadote™ in the US) is the treatment of choice for acute acetaminophen poisoning in most of the world. However, the complicated dosing regimen is prone to errors in preparation and administration. Case report. A 21 year-old woman (70 kg) took an overdose of acetaminophen and ethanol. Her serum acetaminophen concentration was > 200 mg/L. Acetylcysteine infusion was ordered. Due to misreading of the columns in the table in the Acetadote™ package insert, she received a five-fold overdose of 52.5 g of acetylcysteine in 500 mL over 1 h and then 17.5 g of acetylcysteine in 500 mL to run over 4 h. The dose error was detected 20 min into the second infusion. Her acetaminophen concentration fell quickly, and her highest transaminase concentrations occurred day 2. Her hemoglobin and hematocrit quickly dropped from 14.8 g/dL and 44.0% on admission to 6.2 g/dL and 17.3% on day 7. Subsequently she developed hematuria and a rapidly rising serum creatinine. She was transferred to a tertiary care hospital, where she underwent hemodialysis every two days for two weeks, transfusions of packed red blood cells, and plasmapheresis until hematologic testing ruled out thrombotic thrombocytopenia purpura. Discussion. A five-fold overdose of acetylcysteine was followed by unexpected hemolysis and acute renal failure. The mechanism of hemolysis after acetylcysteine overdose is unclear. A simpler infusion regimen with standard concentrations would prevent a similar error.
Effect of Iodine-based Contrast Material on Radiation Dose at CT.

From Shivani Pahwa, MD,* Nicholas K. Schiltz, PhD,† Lee E. Ponsky, MD,‡ Ziang Lu, BA,§ Mark A. Griswold, PhD,*|| Vikas Gulani, MD, PhD*‡|| Departments of Radiology* and Urology,‡ University Hospitals Cleveland Medical Center, Cleveland, Ohio Departments of Population & Quantitative Health Sciences† and Biomedical Engineering,|| Case Western Reserve University, 10900 Euclid Ave, Bolwell B120, Cleveland, OH 44106-0500 e-mail: vikas@case.edu Case Western Reserve University School of Medicine, Cleveland, Ohio§
Ewing's sarcoma of maxilla in an adolescent boy

Ewing's sarcoma is a rarer malignancy, occurring usually in childhood. In majority of reported cases, the occurrence of this tumor is predominantly in the mandible than in the maxilla. Prognosis remains poor in most of the cases; however, better survival rate is possible with early diagnosis and combo therapy. A case of Ewing's sarcoma of the maxilla and its ramifications in the associated structures is presented here. We are also discussing complete clinical, radiographic, and histologic evaluation of the case.
Prevalence of Antenatal Mental Health Problems of Pregnant Women Living in Thai - Myanmar Border Area, Umphang Hospital, Thailand

Objective: To determine the prevalence and risk factors associated with mental health problems in pregnant women. Material and Method: The 245 singleton pregnant women with no previous history of psychiatric illness were asked to complete a Thai General Health Questionnaire (GHQ-12) (mental health screening tool) at Umphang hospital(a primary hospital). The prevalence of mental health problems and associated risk factors were determined. Results: The prevalence of mental health problems in this study was 24.5%. The risk factors of mental health problems in this study were history of abortion, non-Thai speaking, smoking, severe vomiting and vaginal bleeding during pregnancy. Conclusion: The prevalence of mental health problems in pregnant women was high. Pregnant women should be screen for mental health problems particularly in the high risk group.
Dysphagia in children with neuromuscular disorders

A child with Spinal Muscular Atrophy type II was referred for evaluating eating and swallowing problems. The dysphagia evaluation demonstrated coughing during eating and drinking and occasionally stertorous when eating solid food. The videofluoroscopic swallow study showed a late upper esophageal sphincter opening with hypopharyngeal residue, more with solid food than with thin liquid. His lumbar lordosis associated with anterior tilted pelvis and his problems with head balance due to weak neck musculature caused compensatory behavior like a retracted neck and mandible. This position negatively influences the opening of the upper esophageal sphincter. This case supported the idea that dysphagia in Spinal Muscular Atrophy type II is caused by both a bulbar component as well as a treatable posture component.
Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research

Hardly a family in America has been untouched by mental illness. As many as one third of American adults will suffer a diagnosable mental disorder sometime in their life, and 20 percent have a mental disorder at any given time. Although research on the causes and treatment of mental disorders remains vitally important—and indeed major advances are leading to better lives for increasing numbers of people—much greater effort than ever before needs to be directed to prevention. The Senate Appropriations Committee of the U.S. Congress believed that a strategic approach to the prevention of mental disorders was warranted. The Congress mandated the National Institute of Mental Health to enter into an agreement with the Institute of Medicine (IOM) to prepare an integrated report of current research with policy-oriented and detailed long-term recommendations for a prevention research agenda. The specific tasks of the IOM committee, as negotiated with NIMH and the co-funding agencies, were as follows: • Review the status of current research on the prevention of mental illness and problem behaviors and on the promotion of mental health throughout the life span. This should include an understanding of available research knowledge, research priorities, and research opportunities in the prevention research area. • Review the existing federal presence in the prevention of mental disorders and the promotion of mental health, spanning the continuum from research to policy and services. • Provide recommendations on federal policies and programs of ABSTRACT xi Ab ou t th is P D F fil e: T hi s ne w d ig ita l r ep re se nt at io n of t he o rig in al w or k ha s be en r ec om po se d fro m X M L fil es c re at ed f ro m t he o rig in al p ap er b oo k, n ot f ro m t he or ig in al ty pe se tti ng fi le s. P ag e br ea ks a re tr ue to th e or ig in al ; l in e le ng th s, w or d br ea ks , h ea di ng s ty le s, a nd o th er t y pe se tti ng -s pe ci fic fo rm at tin g, h ow ev er , c an no t b e re ta in ed , a nd s om e ty po gr ap hi c er ro rs m ay h av e be en a cc id en t a lly in se rte d. P le as e us e th e pr in t v er si on o f t hi s pu bl ic at io n as th e au th or ita tiv e ve rs io n fo r a ttr ib ut io n.
Shape of Slender Axisymmetric Ventilated Supercavities

The integral-differential equation was obtained to simulate unsteady evolutions of the slender axisymmetric ventilated supercavity with the use of one-dimensional inviscid flow of the incompressible gas in the channel between the cavity surface and the body of revolution. For small ventilation rates, the solution of this equation was expressed as asymptotic series. In the steady case the nonlinear differential equation and its solutions were obtained. It was shown that the ventilation can increase and diminish the supercavity dimensions. Examples of calculations for different hull shapes are presented. At some critical values of the gas injection rate the cavity dimensions can become unbounded. Stability of steady and pulsating gas cavities was investigated in the case of the low gas injection rate.
Evolution of Medication Administration Workflow in Implementing Electronic Health Record System.

Training for information technology (IT) in healthcare has been identified as an important factor in the adoption of electronic health records (EHRs). The Health Information Technology for Economic and Clinical Health (HITECH) Act indicates that workforce training for information literacy is the foundation of EHR adoption and a key catalyst for the meaningful use of EHRs. A computer skills survey was administrated to three rural hospitals in South Carolina to investigate the computer competency and troubleshooting abilities of individual staff members and to determine whether hospital staff are comfortable enough with basic technology to use future EHRs effectively. While results showed that 73.5% of respondents were using EHRs in some part of their work, respondents could use more basic computer training in tasks beyond email and internet activity. Staff respondents were less confident with tasks such as software installation or connecting to printers and troubleshooting activities. In particular, respondents indicated that they had problems in recovering lost data or finding deleted files on a computer. Healthcare personnel with insufficient IT skills can hinder the ability of an organization to integrate EHRs into their daily routine and to achieve meaningful use of EHRs. One key suggestion is to identify local IT experts within the departments who can help bring others up-to-speed and foster more of a team mentality when transitioning to electronic records.
KNOWLEDGE ON BREAST CANCER AND PRACTICE OF BREAST SELF EXAMINATION AMONG SELECTED FEMALE UNIVERSITY STUDENTS IN MALAYSIA

Breast cancer is the most common cancer affecting women in most parts of the world including Malaysia. Even though breast self examination (BSE) is not seen as a relevant cancer screening tool anymore, it still plays an important role in the breast health awareness programme. Aim of the study to determine the knowledge of respondents on breast cancer regarding the risk factors, symptoms, and to determine respondents’ practice of breast self-examination. A cross sectional study was carried out in University Putra Malaysia, data were collected using validated questionnaire developed for this study. Among respondents 197(83.1%) were single, 100 were Malay (42.3%) and 49(20.7%) of the respondents reported having a family history of breast cancer. eighty-seven respondents (36.7%) claimed they had practice BSE. There were statistically significant differences between those who practice and did not practice BSE in term of knowledge regarding risk factors, symptoms of breast cancer, total knowledge of breast cancer and knowledge score of BSE (p-value <0.05). The findings showed that knowledge of breast cancer and the practice of BSE is inadequate among young Malaysian female.
Factors related to paediatric patients' emergency department utilization

To help providers better target services toward specific patient needs, we conducted a prospective study of parents' health beliefs, insurance status and demographics as they predicted paediatric emergency room (ED) utilization. Parents/legal guardians (n = 388) of children ages 0-17 years with minor illnesses completed demographic and health belief questionnaires while waiting for their child to be seen. Post-discharge, children's medical records were reviewed for insurance and utilization information. Higher perceived barriers, higher perceived benefits of care and public insurance status predicted higher ED utilization. Qualitative data indicated that parents used the ED primarily because their regular clinic was closed or had no available appointments. Results are discussed as they relate to a risk profile for higher ED utilization, and practice implications are presented.
Nonalcoholic Fatty Liver Disease Is Not Associated with Thyroid Hormone Levels and Hypothyroidism: A Systematic Review and Meta-Analysis

Background: Whether hypothyroidism is related to nonalcoholic fatty liver disease (NAFLD) is unclear. Thyroid dysfunction is closely related with components of metabolic syndrome. Given the hepatic manifestation of metabolic syndrome, several studies have investigated the association between NAFLD and thyroid dysfunction and have demonstrated inconsistent results. Thus, we conducted a systematic review and meta-analysis to better characterize the association between NAFLD and thyroid dysfunction. Methods: MEDLINE and Embase were searched through July 2016. The primary outcome was the association between NAFLD and subclinical, overt, and overall hypothyroidism. The secondary outcome was the difference in thyroid hormone levels (free triiodothyronine [FT3], free thyroxine [FT4], or thyroid-stimulating hormone [TSH]) between NAFLD patients and non-NAFLD controls. Pooled odds ratios (OR) and 95% CI were calculated using a random-effects model. All continuous data are summarized as the mean difference along with 95% CI. Results: Data were extracted from 14 studies involving 7,191 NAFLD patients and 30,003 controls. NAFLD was not associated with subclinical, overt, or overall hypothyroidism compared with non-NAFLD controls. Patients who had NAFLD did not show a significant difference in FT3, FT4, or TSH compared with non-NAFLD controls. Conclusions: Our meta-analysis demonstrates no significant association between NAFLD and subclinical, overt, or overall hypothyroidism, and we also found no significant difference in thyroid hormone levels between participants with and without NAFLD.
DIABETES MELLITUS AND DIABETIC RETINOPATHY

HLA studies showed that there is an increased relative risk of developing insulin‐dependent diabetes mellitus, irrespective of age of onset, in subjects who are HLA‐Dw3 or HLA‐DR3 positive, with secondary associations with A1, B8 or B18, and in subjects who are Dw4 or DR4 positive, with secondary associations with A2, B15, B40 and Cw3. Subjects who are HLA‐Dw2 or HLA‐DR2 positive, with secondary association with A3 and B7, have a significantly reduced risk of developing the disease. No association has been confirmed in independent studies between HLA and noninsulin‐dependent diabetes mellitus. There is no confirmed evidence that HLA would be involved in the susceptibility to retinopathy once diabetes has developed.
Interleukin 6 in Systemic Sclerosis and Potential Implications for Targeted Therapy

Objective. The purpose of this study was to review the potential importance of interleukin 6 (IL-6) in systemic sclerosis (SSc). Methods. PubMed and Scopus databases and American College of Rheumatology (from 2009–10) and European League Against Rheumatism abstracts (2009–11) were searched using keywords “scleroderma; SSc; cytokines; interleukins; interleukin 6” and publications were excluded if not pertaining to IL-6 in SSc. Data were extracted from selected articles to construct a cell interaction model of the effects of IL-6 in SSc. Results. A total of 416 reports were found (PubMed, n = 82; Scopus, n = 331; 3 abstracts); 372 were excluded (irrelevant) leaving 41 publications and 3 abstracts (39 from PubMed, 18 from Scopus; but 16 were repeated from PubMed search), where 40 suggested IL-6 was important in SSc and 4 did not. Effects of IL-6 in SSc were summarized schematically. Conclusion. Of the 44 publications, 40 suggested that IL-6 may be important in SSc, allowing for a conceptual framework within SSc including effects on macrophages, fibroblasts, plasma cells, monocytes, and extracellular matrix.
The relationship between beverage intake and weight status in children: the Cuenca study.

INTRODUCTION Beverage consumption is becoming more important in current research regarding its possible association with the childhood obesity epidemic. The influence of physical activity on fluid intake has been poorly studied, and cardiorespiratory fitness (CRF) may be a reliable marker for this type of assessment. The present study analysed beverage intake related to weight, adjusted by CRF, in children aged 9 to 11 years. METHODS A cross-sectional, school-based study was conducted on 373 children, aged 9 to 11 years, from the Cuenca province in Spain. To obtain beverage consumption we averaged two 24-h recalls, collected using the YANA-C assessment tool, validated for HELENA study. CRF was assessed by the 20-m shuttle run test. RESULTS Fluid intake was 1483.39 mL/day, and energy ascribed to fluids was 16% of total energy intake. Beverages were 40% of total sugar intake from diet. The largest amount of fluid consumed among thinness boys came from fruit juices and milk drinks. Thinner girls consumed more diet drinks and whole milk than their normal and overweight counterparts, after adjusting for age and CRF. CONCLUSIONS Overweight-obese boys consumed less fruit juices and milk drinks and girls ingested less diet drinks and whole milk than their normal-weight counterparts. These results suggest the importance of investigating the hydration habits of children to draw reliable conclusions about the best way to hydrate in different situations to avoid adiposity increases.
Loss of caveolin-3-dependent regulation of ICa in rat ventricular myocytes in heart failure

β2-Adrenoceptors and L-type Ca2+ current (ICa) redistribute from the t-tubules to the surface membrane of ventricular myocytes from failing hearts. The present study investigated the role of changes in caveolin-3 and PKA signaling, both of which have previously been implicated in this redistribution. ICa was recorded using the whole cell patch-clamp technique from ventricular myocytes isolated from the hearts of rats that had undergone either coronary artery ligation (CAL) or equivalent sham operation 18 wk earlier. ICa distribution between the surface and t-tubule membranes was determined using formamide-induced detubulation (DT). In sham myocytes, β2-adrenoceptor stimulation increased ICa in intact but not DT myocytes; however, forskolin (to increase cAMP directly) and H-89 (to inhibit PKA) increased and decreased, respectively, ICa at both the surface and t-tubule membranes. C3SD peptide (which decreases binding to caveolin-3) inhibited ICa in intact but not DT myocytes but had no effect in the presence of H-89. In contrast, in CAL myocytes, β2-adrenoceptor stimulation increased ICa in both intact and DT myocytes, but C3SD had no effect on ICa; forskolin and H-89 had similar effects as in sham myocytes. These data show the redistribution of β2-adrenoceptor activity and ICa in CAL myocytes and suggest constitutive stimulation of ICa by PKA in sham myocytes via concurrent caveolin-3-dependent (at the t-tubules) and caveolin-3-independent mechanisms, with the former being lost in CAL myocytes. NEW & NOTEWORTHY In ventricular myocytes from normal hearts, regulation of the L-type Ca2+ current by β2-adrenoceptors and the constitutive regulation by caveolin-3 is localized to the t-tubules. In heart failure, the regulation of L-type Ca2+ current by β2-adrenoceptors is redistributed to the surface membrane, and the constitutive regulation by caveolin-3 is lost.
A Randomized Controlled Trial to Improve Self-Care in Patients with Heart Failure Living in Rural Areas

5 5 Na Na Nati ti tion on onal al al H H Hea ea eart rt rt, , Lu Lu Lung ng ng a a and nd nd B B Blo lo lood od od I I Ins ns nsti ti titu tu tute te te, , Be Be Beth th thes es esda da da, , MD MD MD Abstract Background—Patients with heart failure (HF) who live in rural areas have less access to cardiac
Does Aerobic Training Affect Maximum Voluntary Ventilation

Background and Objectives: Aerobic exercise is an important component of pulmonary rehabilitation for patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the effect of aerobic training on Maximum Voluntary Ventilation (MVV) which is a measure of respiratory muscle performance. Methods: We recruited forty apparently healthy male medical students aged 17-20 years. Informed consent was obtained. Participants were non-athletes, non-smokers, non-obese and non-alcoholics. Randomization into experimental and control groups (20 each), was carried out with a table of random numbers. The experimental group participated in a 16 weeks aerobic exercise plan. Subjects were asked to refrain from tea, coffee, chocolates and caffeinated soft-drinks on the day of recording Spirometry. MVV was recorded before the commencement of training and at the end of training. The MVV maneuver was demonstrated to all the subjects. MVV was recorded by a computerized spirometer (CPFS/DUSB, Medgraphics Company) in standing position. Subjects were instructed to ventilate with her or his maximal ventilation volume and frequency for 15 seconds. The obtained value was multiplied by 4 to get MVV in L/min. Results: The data were analyzed by paired ‘t’ test. P < 0.05 was considered significant. There was significant improvement in MVV in the intervention group at the end of training. Conclusion: In conclusion, the current study has shown that, there is significant positive relationship between aerobics training and respiratory muscle performance.