Miracle-dz/UniFAR-FTUs huggingface dataset:
A multivariate analysis of objective voice changes after thyroidectomy without laryngeal nerve injury.

OBJECTIVE To evaluate the impact of thyroidectomy and the possible effects of factors such as patient sex, operation type, and surgeon experience on objective voice parameters of patients undergoing thyroidectomy without laryngeal nerve injury. DESIGN Prospective study. SETTING University hospital. PATIENTS Thirty-six patients undergoing primary thyroidectomy because of thyroid disease. MAIN OUTCOME MEASURES The effect of thyroidectomy on voice was examined by recording the voices of the patients before and 1 week after thyroidectomy. The Multi-Dimensional Voice Program was used for capturing and analyzing the voice samples. RESULTS On postoperative examination of objective voice changes, thyroidectomy had no multivariate effect on the combination of voice parameters. Patient sex, type of surgery, and surgeon experience had no effect on the combination of voice parameters before and after thyroidectomy. Regardless of within-patient factors (type of surgery, patient sex, and surgeon experience), 4 acoustic parameters (highest fundamental frequency, standard deviation of average fundamental frequency, phonatory average fundamental frequency range in semitones, and degree of subharmonics) significantly decreased after thyroidectomy (P < .05). Although they tended to be worse, none of the acoustic parameters showed significant changes in male patients. However, significant changes in some of the acoustic parameters of female patients were observed. Highest fundamental frequency, standard deviation of average fundamental frequency, phonatory average fundamental frequency range in semitones, absolute jitter, relative average perturbation, pitch perturbation quotient, shimmer in decibels, percentage of shimmer, amplitude perturbation quotient, noise to harmonic ratio, and degree of subharmonics values were all lower in female patients after thyroidectomy (P < .05). CONCLUSIONS Voice changes may occur after thyroidectomy without any evident laryngeal injury, and deterioration and amelioration of acoustic parameters can be observed to occur differently among male and female patients. Preoperative and postoperative objective voice analyses may be helpful in documenting voice changes.
Basic Statistics: A Primer for the Biomedical Sciences.

This is a short book "designed to serve as a textbook for students in the biomedical fields. " It will also be of use to research workers as a basic statistical reference which contains computational formulas for some of the most frequently used methods. The subject matter includes descriptive statistics, confidence intervals, tests of hypotheses on population means and proportions, and a chapter on linear regression and correlation. The presentation of computational procedures is exceptionally clear and care has been taken to provide the simplest formulas for each technique. Although printing errors are numerous, the major shortcoming of the book is that it is too brief. The author states, "No attempt at completeness has been made; several topics whose inclusion seemed desirable were excluded because I felt they were not absolutely necessary. " Some of the topics omitted should not have been. These include: (1) Fisher's exact test for 2×2 contingency tables
Acute and chronic changes in the subglottis induced by graded carbon dioxide laser injury in the rabbit airway.

OBJECTIVE To investigate the repair process following carbon dioxide laser injury to the upper airway mucosa (UAM) during the development of chronic subglottic stenosis (SGS). DESIGN Animals were assigned to either sham control (cricothyroidotomy only) or injured (cricothyroidotomy and posterior subglottic laser) groups using various carbon dioxide laser exposures (8, 12, and 16 W) for 4 seconds. SUBJECTS Twenty-four New Zealand white rabbits. INTERVENTIONS The subglottis was approached via cricothyroidotomy. Sham control airways were immediately closed, whereas injured airways were subjected to graded carbon dioxide laser exposures prior to closure. Airways were endoscopically monitored preoperatively, postoperatively, and on postoperative days 7, 14, 28, 42, 56, 70, and 84. Animals were killed at 14 and 84 days. Subglottic tissue was harvested for histologic evaluation (reepithelialization, extracellular matrix, vascularity, and inflammation). MAIN OUTCOME MEASURES Endoscopic visualization and histologic analysis. RESULTS (1) Increases in UAM thickness (up to 5 times the thickness of normal mucosa) were observed but were limited primarily to the lamina propria. The mucosal epithelium regenerated without chronic changes. Focal areas of cartilage repair were encountered acutely after injury and to a greater extent in the chronic phases of repair. (2) Acutely, the thickened lamina propria comprised poorly organized extracellular matrix components and demonstrated increases in blood vessel size and number. (3) Histologic changes present in the acute phase only partially resolved in progression to chronic SGS. Chronic SGS was characterized by thick collagen fiber bundles extending into the remodeled subglottic cartilage. CONCLUSIONS The carbon dioxide laser induces acute changes to lamina propria architecture and vascularity that persist chronically. Elucidating responsible signaling pathways may facilitate the development of therapeutic agents to prevent or reduce the formation of SGS.
Effect of prior stimulant treatment for attention-deficit/hyperactivity disorder on subsequent risk for cigarette smoking and alcohol and drug use disorders in adolescents.

OBJECTIVE To examine the effects of early stimulant treatment on subsequent risk for cigarette smoking and substance use disorders (SUDs) in adolescents with attention-deficit/hyperactivity disorder (ADHD). DESIGN Case-controlled, prospective, 5-year follow-up study. SETTING Massachusetts General Hospital, Boston. PARTICIPANTS Adolescents with and without ADHD from psychiatric and pediatric sources. Blinded interviewers determined all diagnoses using structured interviews. Intervention Naturalistic treatment exposure with psychostimulants for ADHD. MAIN OUTCOME MEASURES We modeled time to onset of SUDs and smoking as a function of stimulant treatment. RESULTS We ascertained 114 subjects with ADHD (mean age at follow-up, 16.2 years) having complete medication and SUD data; 94 of the subjects were treated with stimulants. There were no differences in SUD risk factors between naturalistically treated and untreated groups other than family history of ADHD. We found no increased risks for cigarette smoking or SUDs associated with stimulant therapy. We found significant protective effects of stimulant treatment on the development of any SUD (hazard ratio [HR], 0.27; 95% confidence interval [CI], 0.13-0.60; chi(2)(113) = 10.57, P = . 001) and cigarette smoking (HR, 0.28; 95% CI, 0.14-0.60; chi(2)(111) = 10.05, P = . 001) that were maintained when controlling for conduct disorder. We found no effects of time to onset or duration of stimulant therapy on subsequent SUDs or cigarette smoking in subjects with ADHD. CONCLUSION Stimulant therapy does not increase but rather reduces the risk for cigarette smoking and SUDs in adolescents with ADHD.
Childhood trajectories of anxiousness and disruptiveness as predictors of suicide attempts.

OBJECTIVE To investigate the association of childhood trajectories of anxiousness and disruptiveness with suicide attempts in early adulthood. DESIGN Prospective cohort study. SETTING Public francophone schools in Quebec, Canada, from the 1986 to 1988 school years. PARTICIPANTS Of 4,488 French Canadian children attending kindergarten, a representative group of 1,001 boys and 999 girls was chosen for follow-up. Of these, 1,144 individuals participated in the study during early adulthood. MAIN OUTCOME MEASURES Suicide attempt histories by early adulthood, adjusted odds ratios (ORs) associated with membership in high- vs low-risk trajectories of anxiousness and disruptiveness, moderation (by sex), and mediation (by adolescent Axis I disorders). RESULTS We observed 4 distinct developmental profiles of anxiousness and disruptiveness and a frequent co-occurrence of similar levels of these traits. In contrast to anxiousness trajectories (OR = 1.60; 95% confidence interval, 1.00-2.65), disruptiveness (OR = 1.80; 95% confidence interval, 1.03-3.13) and joint (OR = 1.88; 95% confidence interval, 1.05-3.37) trajectories made statistically significant contributions to suicide attempts. We found no support for mediation by adolescent anxiety/mood or disruptive disorders. Sex, however, moderated the effect of joint trajectories, increasing the risk of suicide attempts in women (OR = 3.60; Wald chi(2) = 10.93; P < . 001) but not men (OR = 0.80; Wald chi(2) = 0.23; P = . 64) displaying both anxious and disruptive traits as children. CONCLUSIONS Anxious-disruptive girls and disruptive boys appear to be more likely than their peers to attempt suicide by early adulthood. Preventive efforts will require more research into the possible mechanisms behind this early sex difference, ie, gene-environment interplays and nonpsychiatric mediators.
Sleep problems in children with attention-deficit/hyperactivity disorder: prevalence and the effect on the child and family.

OBJECTIVES To determine the prevalence of sleep problems in children with attention-deficit/hyperactivity disorder (ADHD) and their associations with child quality of life (QOL), daily functioning, and school attendance; caregiver mental health and work attendance; and family functioning. DESIGN Cross-sectional survey. SETTING Pediatric hospital outpatient clinic, private pediatricians' offices, and ADHD support groups in Victoria, Australia. PARTICIPANTS Schoolchildren with ADHD. Main Exposure Attention-deficit/hyperactivity disorder. OUTCOME MEASURES Primary measure was caregivers' reports of their children's sleep problems (none, mild, or moderate or severe). Secondary outcomes were (1) child QOL (Pediatric Quality of Life Inventory), daily functioning (Daily Parent Rating of Evening and Morning Behavior scale), and school attendance, (2) caregiver mental health (Depression Anxiety Stress Scale) and work attendance, and (3) family functioning (Child Health Questionnaire subscales). Caregivers also reported on how their pediatrician treated their children's sleep problems. RESULTS Two hundred thirty-nine of 330 (74%) eligible families completed the survey. Child sleep problems were common (mild, 28.5%; moderate or severe, 44.8%). Moderate or severe sleep problems were associated with poorer child psychosocial QOL, child daily functioning, caregiver mental health, and family functioning. After adjusting for confounders, all associations held except for family impacts. Compared with children without sleep problems, those with sleep problems were more likely to miss or be late for school, and their caregivers were more likely to be late to work. Forty-five percent of caregivers reported that their pediatricians had asked about their children's sleep and, of these, 60% reported receiving treatment advice. CONCLUSIONS Sleep problems in children with ADHD are common and associated with poorer child, caregiver, and family outcomes. Future research needs to determine whether management of sleep problems can reduce adverse outcomes.
Antecedents and sequelae of sudden parental death in offspring and surviving caregivers.

OBJECTIVES To examine the psychiatric antecedents that put parents at risk for early death, and the psychological sequelae of bereavement in offspring and caregivers. DESIGN A population-based study. SETTING Bereaved families were recruited through the coroner's records and by advertisement. Control families were recruited by random-digit dialing and advertisement. PARTICIPANTS Families with biological offspring from 7 to 25 years of age in which 1 parent died of suicide, accident, or sudden natural death were included (n = 140). Controls (n = 99) had 2 living parents and their biological offspring and had no death of a first-degree relative within the past 2 years. MAIN OUTCOME MEASURES Lifetime psychiatric history for deceased parents (probands) and new-onset psychiatric disorders, self-reported symptoms, and functional status in offspring and surviving caregivers. RESULTS Bipolar disorder, substance abuse, and personality disorders are more common in probands who died of suicide or accident than in control parents. Bereaved offspring and their caregivers were at increased risk for depression and posttraumatic stress disorder. Bereaved offspring had a 3-fold (95% confidence interval, 1.3-7.0) increased risk of depression, even after controlling for antecedent and concomitant risk factors. Offspring bereaved by suicide showed similar outcomes compared with those bereaved by other types of death. CONCLUSIONS Bereavement conveys an increased risk of depression and posttraumatic stress disorder above and beyond other vulnerability factors. Better integration of medical and psychiatric care may prevent premature parental death, but once it occurs, physicians should be alert to the increased risk for depression and posttraumatic stress disorder in bereaved offspring and their caregivers.
Infektionen und Kolonisationen: Was können wir verbessern?

Zusammenfassung Hintergrund und Fragestellung | Infektions- und Kolonisationsausbrüche stellen eine zunehmende Belastung für Krankenhäuser und das Gesundheitssystem im Allgemeinen dar und gefährden mitunter die Sicherheit der Patienten. Methode | Seit Ende 2013 werden komplexere Ausbruchsuntersuchungen durch das Ausbruchmanagementteam des Deutschen Beratungszentrums für Hygiene in Freiburg im Rahmen eines Qualitätssicherungsprojektes erfasst. Wir haben nun die Daten für den Zeitraum Ende 2013 bis Januar 2015 ausgewertet. Ergebnisse | Noroviren waren mit Abstand häufigste Ausbruchsverursacher. Bei den bakteriellen Ausbrüchen dominierten gramnegative Erreger. Die Ausbruchdauer variierte zwischen 6 und 185 Tagen. In 24 % der Ausbrüche handelte es sich um Kolonisationsausbrüche. Insgesamt wurden bei allen 29 Ausbrüchen zusammen 187 erkrankte Patienten, 50 kolonisierte Patienten und 92 Erkrankte beim Personal (64 Norovirus- bzw. 20 Influenzainfektionen, 8 Scabiesfälle) registriert. Todesfälle traten nicht auf. Folgerung | Die mangelnde Compliance des Personals mit Schutzimpfungen bzw. prophylaktischer Therapie, der fehlerhafte Gebrauch persönlicher Schutzausrüstung und das Nichteinhalten von Karenzzeiten vor Wiederaufnahme der Arbeit im Krankheitsfall spielen bei protrahierten Ausbruchsgeschehen vor allem bei viraler Genese aber auch bei Krätze eine wichtige Rolle. Die zeitnahe deskriptive epidemiologische Analyse hat für die erfolgreiche Identifizierung von Übertragungswegen und möglicher Punktquellen eine wichtige Bedeutung.
Fanconi anaemia: genetics, molecular biology, and cancer – implications for clinical management in children and adults

Fanconi anaemia (FA) is an inherited disease with congenital and developmental abnormalities, cross‐linker hypersensitivity and extreme cancer predisposition. With better understanding of the genetic and molecular basis of the disease, and improved clinical management, FA has been transformed from a life‐limiting paediatric disease to an uncommon chronic condition that needs lifelong multidisciplinary management, and a paradigm condition for the understanding of the gene‐environment interaction in the aetiology of congenital anomalies, haematopoiesis and cancer development. Here we review genetic, molecular and clinical aspects of FA, and discuss current controversies and future prospects.
Lynch syndrome: five unanswered questions

Despite the great advances that have occurred in the century following the first description of a Lynch syndrome (LS) family and more especially, in more than 20 years since the discovery of causal mutations in the mismatch repair genes (MMR), long-standing clinical questions remain unanswered. Moreover, as a result of novel technologies, new questions have arisen. With this commentary, we aim to briefly cover some of these aspects of LS. We will focus on current challenges regarding the definition of LS-related tumors, their prevention and early detection, the role of next-generation sequencing (NGS) in the molecular diagnostics of LS and advances in the treatment of LS tumors.
Prevention Revisited— Summary of Scientific Symposium

A symposium, "Prevention Revisited", was held in September of 1990 in Rochester, New York, as part of the 75th Anniversary celebration of the Eastman Dental Center. The symposium covered a broad range of topics, including risk assessment for oral diseases, the diagnosis and classification of periodontal diseases, caries prevention, fluorides, dental materials, TMJ disorders, and the geriatric patient. Each topic was approached from the perspective of prevention: past accomplishments, present status, and future directions. A format of major presentations, reactor papers, and discussion was used.
Prevalence of Hepatitis B Surface Antigen and Anti- HIV Antibodies among Patients on Maintenance Haemodialysis in Douala - Cameroon

Background Compared to the general population, Hemodialysis (HD) patients have been shown to be at higher risk of blood borne viral infection among which Hepatitis B virus (HBV) and Human immune deficiency virus (HIV). With increasing access to HD in Cameroon, we opted to assess the prevalence of these viral infections among chronic HD patients of Douala General Hospital dialysis center. Methods From October to December 2012, all consenting patients of this center were screened for hepatitis B surface antigen (HBsAg) and anti-HIV antibodies. HBsAg was determined using a commercial third generation assay (BIOREX®). Anti HIV was first determined using a rapid HIV 1 and 2 Ag/Ab Combo test and confirmed using ImmunoComb ® II HIV 1 & 2 BiSpot. Results A total of 166 patients were studied 63.9% of whom were men. Mean age was 49.2 ± 14.2 years and median duration in dialysis was 24months [(Interquartile range (QR):8 – 42]. Hypertension was the main aetiology of end stage renal disease (ESRD) in 25.9% of patients. In the study population, 18.7% of patients had markers of at least one viral infection; HBsAg 7.8% and HIV 10.8% with only one patient (0.6%) being co-infected. Longer duration in dialysis was associated with lower prevalence of both infections, odd ratio (OR) 0.2 (95%CI 0.03 – 0.8, p<0.01) for HBsAg and 0.3 (95%CI 0.1 – 1.0, p<0.05) for HIV. No association was found with a history of STI, scarification and previous transfusions. Conclusion HBV and HIV infections are common among dialysis patients in Douala thereby warranting strict adherence to infection control measures. Key words: Hepatitis B, HIV, end stage renal disease, hemodialysis
Wide allelic heterogeneity with predominance of large IDS gene complex rearrangements in a sample of Mexican patients with Hunter syndrome

Hunter syndrome or mucopolysaccharidosis type II (MPSII) is caused by pathogenic variants in the IDS gene. This is the first study that examines the mutational spectrum in 25 unrelated Mexican MPSII families. The responsible genotype was identified in 96% of the families (24/25) with 10 novel pathogenic variants: c.133G>C, c.1003C>T, c.1025A>C, c. 463_464delinsCCGTATAGCTGG, c. 754_767del, c. 1132_1133del, c.1463del, c.508‐1G>C, c.1006+1G>T and c. (‐217_103del). Extensive IDS gene deletions were identified in four patients; using DNA microarray analysis two patients showed the loss of the entire AFF2 gene, and epilepsy developed in only one of them. Wide allelic heterogeneity was noted, with large gene alterations (e.g. IDS/IDSP1 gene inversions, partial to extensive IDS deletions, and one chimeric IDS‐IDSP1 allele) that occurred at higher frequencies than previously reported (36% vs 18.9–29%). The frequency of carrier mothers (80%) is consistent with previous descriptions (>70%). Carrier assignment allowed molecular prenatal diagnoses. Notably, somatic and germline mosaicism was identified in one family, and two patients presented thrombocytopenic purpura and pancytopenia after idursulfase enzyme replacement treatment. Our findings suggest a wide allelic heterogeneity in Mexican MPSII patients; DNA microarray analysis contributes to further delineation of the resulting phenotype for IDS and neighboring loci deletions.
Exhaled nitric oxide in acute respiratory syncytial virus bronchiolitis.

OBJECTIVE To investigate fractional exhaled nitric oxide (FeNO) levels in infants during acute respiratory syncytial virus (RSV) bronchiolitis and during convalescence. DESIGN Prospective cohort study. Comparison of FeNO levels between infants with laboratory-confirmed acute RSV bronchiolitis and 2 control groups: healthy infants and infants with recurrent wheezing. SETTING The Department of Pediatric Emergency Medicine and the Pediatric Pulmonary Clinic of the Tel Aviv Medical Center from November 2008 to July 2009. The FeNO levels were measured at referral and at 2 visits over 4 months after convalescence. The FeNO level was measured using the multiple-breath exhalation technique. PARTICIPANTS Forty-four infants with acute RSV bronchiolitis (mean [SD] age, 6.8 [7.3] months), 21 infants with recurrent wheezing (mean [SD] age, 10.8 [7.59] months), and 32 age-matched healthy controls (mean [SD] age, 6.8 [9.1] months). Follow-up data were available for 22 children (55%) for the first follow-up visit and for 11 children (25%) for the second follow-up visit. EXPOSURE Acute RSV bronchiolitis. MAIN OUTCOME MEASURES The FeNO levels during acute RSV bronchiolitis vs controls and FeNO levels during follow-up vs acute-stage disease. RESULTS Mean FeNO levels for RSV-positive infants were significantly lower compared with healthy controls and infants with recurrent wheezing: mean (SD), 1.89 (1.76) parts per billion (ppb), 7.28 (4.96) ppb, and 4.86 (7.49) ppb, respectively (P<.001). The FeNO levels at the 2- and 4-month follow-up visits increased to 7.74 (5.13) ppb and 11.37 (6.29) ppb, respectively (P=.001). CONCLUSIONS The FeNO levels are temporarily reduced during acute RSV bronchiolitis and increase during convalescence to normal levels and higher. The mechanisms for this suppression and its relation to future wheezing and asthma need to be studied.
Expanding the genotypic spectrum of Perrault syndrome

Perrault syndrome is a rare autosomal recessive disorder characterized by sensorineural hearing loss (SNHL) in both sexes and primary ovarian insufficiency in 46, XX karyotype females. Biallelic variants in five genes are reported to be causative: HSD17B4, HARS2, LARS2, CLPP and C10orf2. Here we present eight families affected by Perrault syndrome. In five families we identified novel or previously reported variants in HSD17B4, LARS2, CLPP and C10orf2. The proband from each family was whole exome sequenced and variants confirmed by Sanger sequencing. A female was compound heterozygous for a known, p.(Gly16Ser) and novel, p.(Val82Phe) variant in D‐bifunctional protein (HSD17B4). A family was homozygous for mitochondrial leucyl aminocyl tRNA synthetase (mtLeuRS) (LARS2) p.(Thr522Asn), previously associated with Perrault syndrome. A further family was compound heterozygous for mtLeuRS, p.(Thr522Asn) and a novel variant, p.(Met117Ile). Affected individuals with LARS2 variants had low frequency SNHL, a feature previously described in Perrault syndrome. A female with significant neurological disability was compound heterozygous for p.(Arg323Gln) and p.(Asn399Ser) variants in Twinkle (C10orf2). A male was homozygous for a novel variant in CLPP, p.(Cys144Arg). In three families there were no putative pathogenic variants in these genes confirming additional disease‐causing genes remain unidentified. We have expanded the spectrum of disease‐causing variants associated with Perrault syndrome.
Effect of chronic garlic feeding on some haematological parameters

Some hematological parameter were investigated in rats fed with garlic juice (200mg/kg) daily for thirty days. Garlic feeding for 30 days significantly (P monocytes and the lymphocytes. No significant changes were observed in the basophil and eosinophil counts of animal fed with garlic, when compared with control.