Miracle-dz/UniFAR-FTUs huggingface dataset:
Anastrozole Is Superior to Tamoxifen as First-Line Therapy in Hormone Receptor Positive Advanced Breast Carcinoma Results of Two Randomized Trials Designed for Combined Analysis

BACKGROUND Two randomized, double-blind trials have compared tamoxifen 20 mg daily and the selective, nonsteroidal aromatase inhibitor anastrozole 1 mg daily as first-line therapy for advanced breast carcinoma (ABC) in postmenopausal women. The trials were prospectively designed to allow for combined data analyses. METHODS The combined study population included 1021 postmenopausal women (median age, 67 years [range, 30–92]) with ABC whose tumors were either estrogen and/or progesterone receptor positive or of unknown receptor status. Primary endpoints were time to progression (TTP), objective response, and tolerability. RESULTS At a median duration of follow-up of 18.2 months, anastrozole was at least equivalent to tamoxifen in terms of median TTP (8.5 and 7.0 months, respectively; estimated hazard ratio [tamoxifen relative to anastrozole], 1.13 [lower 95% confidence level, 1.00]). In a retrospective subgroup analysis, anastrozole was superior to tamoxifen with respect to TTP (median values of 10.7 and 6.4 months for anastrozole and tamoxifen, respectively, two-sided P = 0.022) in patients with estrogen and/or progesterone receptor positive tumors (60% of combined trial population). In terms of objective response, 29.0% of anastrozole and 27.1% of tamoxifen patients achieved either a complete response (CR) or a partial response (PR). Clinical benefit (CR + PR + stabilization of ≥ 24 weeks) rates were 57.1% and 52.0% for anastrozole and tamoxifen, respectively. Both anastrozole and tamoxifen were well tolerated. Anastrozole led to significantly fewer venous thromboembolic (P = 0.043; not adjusted for multiple comparisons) events, and vaginal bleeding was reported in fewer patients treated with anastrozole than with tamoxifen. CONCLUSIONS In postmenopausal women with hormonally sensitive ABC, anastrozole should be considered as the new standard first-line treatment. Cancer 2001;92:2247–58. © 2001 American Cancer Society.
Knowledge, Attitude and Practice towards Cervical Cancer among Reproductive Health Clients at the University of Science & Technology Hospital-Sana'a in Yemen

Background: Cervical Cancer is the second most common cancer among women worldwide. It is mostly caused by a virus called human papilloma virus (HPV). Females can get HPV by having sexual contact with someone who has it. It is one of the most preventable cancers by the routine cervical screenings and HPV vaccination.Aim: To assess the knowledge, attitude and practice towards cervical cancer among women visiting the University of Science & Technology Hospital- Sana'a.Methods: This is a descriptive cross-sectional study carried out in July, 2009 on women visiting the gynaecological out-patient clinic at the University of Science & Technology Hospital- Sana'a. A sample of 283 women was selected by convenience sampling. The study was conducted by means of a questionnaire survey.Results: Among the participants, 80.6% (228) had various levels of knowledge about cervical cancer. 42.3% knew that viral infection by HPV may be the cause of cervical cancer. As regard to the clinical presentation of cancer cervix, women knew that vaginal bleeding (77.2%), pelvic pain (43.9%), menstrual disturbances (35.1%) were the commonest. As for prevention of cervical cancer, 72% had some knowledge; 59% have an idea about the periodic cervical screening, while only 18% knew the HPV vaccine.Conclusion: Women in this study had a satisfactory knowledge and awareness about cervical cancer; its risk factors, clinical presentation, prevention. However, their knowledge on the management of cervical cancer was mostly false.
Demography and student success: Early warning tools to drive intervention

Abstract Grounded in the concept of organizational demography, the authors investigate various demographic, precollege, and socioeconomic student-level attributes that universities readily house, and use them to create customized early warning tools to advance students’ academic success. Upon a review of prior studies of sociodemographic influences in higher education, the authors examine two facets of academic success—student performance and retention—and create a decision support model for each. Such data-driven early warning tools are immediately useful in undergraduate business education and can help university staff, administrators, and faculty make customized decisions regarding data-driven support strategies for improving key student outcomes.
Mercury Concentrations of Maternal and Umbilical Cord Blood in Korean Pregnant Women: Preliminary Study

Objectives: To evaluate the level of maternal and prenatal mercury exposure and to analyze the related factors. Methods: Fifty-nine pregnant women were recruited into this study after obtaining informed consent. Samples were collected at delivery from normal pregnant women who were living in the city of Busan, Korea. Mercury concentrations in maternal and umbilical cord blood samples were measured using a gold-amalgam collection method. The total and methyl mercury levels of 36 of the 59 pregnant women were analyzed after randomization, and the results were compared. Results: The mean total mercury concentration was 3.16±1.21 ppb and 5.43±2.22 ppb in maternal and cord blood, respectively. The average, maternal blood mercury level was lower than the prescribed toxic limit for human (WHO, 5 ppb), whereas the cord blood mercury was higher. The mercury exposure level exceeded the WHO recommendation in 5 (8.47%) cases of maternal blood and 29 of (49.15%) cord blood. There was a significant correlation between maternal and cord blood mercury concentrations. Total mercury and methyl mercury concentrations of the 36 random pregnant women were 3.06±1.17 ppb, and 2.60±1.11 ppb in maternal blood, and 5.20±2.36 ppb, and 4.70±1.97 ppb in cord blood, respectively. Methyl mercury accounted for 85.0% of the total mercury in maternal blood and 90.4% in cord blood. There was a significant correlation between total and methyl mercury concentrations.
A Sandbox-Based Approach to the Deobfuscation and Dissection of PHP-Based Malware

The creation and proliferation of PHP-based Remote Access Trojans (or web shells) used in both the compromise and post exploitation of web platforms has fuelled research into automated methods of dissecting and analysing these shells. Current malware tools disguise themselves by making use of obfuscation techniques designed to frustrate any efforts to dissect or reverse engineer the code. Advanced code engineering can even cause malware to behave differently if it detects that it is not running on the system for which it was originally targeted. To combat these defensive techniques, this paper presents a sandbox-based environment that aims to accurately mimic a vulnerable host and is capable of semi-automatic semantic dissection and syntactic deobfuscation of PHP code.
Sex Differences in 1-Year Outcomes After Percutaneous Coronary Intervention in the Veterans Health Administration.

BACKGROUND Advancements in percutaneous coronary intervention (PCI) for treating obstructive coronary artery disease have reduced major adverse events, including mortality. Yet, evidence as to whether women and men experience similar outcomes is mixed. The objective was to examine sex differences in 1-year major adverse cardiac outcomes for the national population of patients undergoing PCI at Veterans Health Administration (VA) cardiac catheterization laboratories. METHODS All Veterans undergoing PCI at VA hospitals between October 1, 2007 and September 30, 2013 (N = 64,757; Women = 1,040) were included. Cox proportional hazards models compared 1-year postprocedural outcomes [rehospitalization for myocardial infarction (MI), all-cause mortality, and major adverse cardiovascular events (MACE)] by sex. RESULTS Women Veterans undergoing PCI were more likely to be younger, black, obese, and have chronic depression and less likely to have common cardiovascular risk factors and to have had prior cardiac events than Veteran men. One-year rates for women versus men were 2.1% and 2.5% for rehospitalization (p-value = 0.57); 3.5% and 4.9% for mortality (p-value = 0.14), and 5.4% and 6.9% for MACE (p-value = 0.18). There were no significant sex differences in any of the outcomes in Cox proportional hazards models. CONCLUSIONS Despite differences in clinical risk factors at the time of PCI, women and men Veterans treated at VA cardiac catheterization laboratories experienced comparable 1-year rehospitalization for MI, mortality, and MACE post-PCI. These results demonstrated similar 1-year post-PCI outcomes for men and women in a national population of patients who have more comorbidities and mental health issues than the general population.
Role of 18F-FDG PET/CT in Posttreatment Evaluation of Anal Carcinoma

The aim of this study was to evaluate the relevance of PET/CT and 18F-FDG as a strategy for response evaluation after chemoradiotherapy for anal cancer. For this, the performance of posttreatment 18F-FDG PET/CT, the impact on patient care, and the predictive value of metabolic response were assessed. Methods: This was a retrospective and multicenter analysis of 87 patients treated by chemoradiotherapy for anal squamous cell carcinoma between October 2007 and October 2013. All patients underwent systematic posttreatment 18F-FDG PET/CT and were followed with at least a clinical examination every 4 mo for 2 y and every 6 mo thereafter. Disease progression was confirmed by biopsy for all patients in the case of local recurrence before surgery. Kaplan–Meier and Cox regression models were used to test for associations between metabolic or clinical endpoints and progression-free survival (PFS) or cause-specific survival (CSS). Results: The median follow-up was 25 mo. 18F-FDG PET/CT was performed 1–8 mo (median, 4 mo) after completion of chemoradiotherapy. Overall, 25 patients relapsed and 13 died. The posttherapy 18F-FDG PET/CT did not show any abnormal 18F-FDG uptake (complete metabolic response [CMR]) in 55 patients whereas 32 displayed incomplete response (non-CMR): 15 patients with partial response and 17 with disease progression. The sensitivity of 18F-FDG PET/CT to detect residual tumor tissue was 92% (95% confidence interval [CI], 75%–97%), specificity was 85% (95% CI, 75%–92%), positive predictive value was 72% (95% CI, 61%–90%), and negative predictive value was 96.4% (95% CI, 90%–98.7%). The 2-y PFS was 96% (95% CI, 90–100) for patients with CMR and 28% (95% CI, 14–47) for non-CMR patients (P < 0.0001). The 2-y CSS was 100% for patients with CMR and 59% (95% CI, 42–84) for those without CMR (P < 0.0001). 18F-FDG PET/CT changed patient management in 14 cases (16%), with relevant modifications in 12 (14%). A Cox proportional hazards model of survival outcome indicated that a CMR was the only significant predictor of PFS and CSS (P < 0.0001). Conclusion: 18F-FDG PET/CT shows good accuracy in posttreatment evaluation of anal cancer and has a relevant impact on patient management. Moreover, CMR is associated with good survival outcome. Thus, 18F-FDG PET/CT may play a significant role during posttreatment follow-up of anal cancer.
Chromoblastomycosis

Chromoblastomycosis is a chronic fungal infection of the skin and subcutaneous tissue. The infection usually results from a traumatic injury and inoculation of microorganism from a specific group of dematiaceous fungi (usually Fonsecaea pedrosoi, Phialophora verrucosa, Cladophialophora carrionii). In the tissues fungi produce characteristic sclerotic cells or muriform cells. Dermal lesions can range from small nodules to large papillary-like eruptions. The disease has been described worldwide but the prevalence is higher in rural populations in countries with a tropical or subtropical climate, such as Madagascar in Africa and Brazil in South America. Diagnostic techniques are based on direct examination, culture and histopathology. Despite a variety of treatment modalities, which include long courses of antifungals, surgical excision and destructive physical therapies, the disease remains one of the most difficult deep mycotic infections to eradicate.
Highly Accurate Machine Fault Diagnosis Using Deep Transfer Learning

We develop a novel deep learning framework to achieve highly accurate machine fault diagnosis using transfer learning to enable and accelerate the training of deep neural network. Compared with existing methods, the proposed method is faster to train and more accurate. First, original sensor data are converted to images by conducting a Wavelet transformation to obtain time-frequency distributions. Next, a pretrained network is used to extract lower level features. The labeled time-frequency images are then used to fine-tune the higher levels of the neural network architecture. This paper creates a machine fault diagnosis pipeline and experiments are carried out to verify the effectiveness and generalization of the pipeline on three main mechanical datasets including induction motors, gearboxes, and bearings with sizes of 6000, 9000, and 5000 time series samples, respectively. We achieve state-of-the-art results on each dataset, with most datasets showing test accuracy near 100%, and in the gearbox dataset, we achieve significant improvement from 94.8% to 99.64%. We created a repository including these datasets located at mlmechanics.ics. uci.edu.
Is It Safe to Discontinue Statins? Does Stopping Statins Improve Quality of Life: Yes and No.

A noninferiority study states that the primary end point for the experimental treatment is worse than that for the positive control treatment by a prespecified margin, and rejects the null hypothesis at the prespecified level of statistical significance to support a claim of noninferiority. The p value was 0.36. The trial primary outcome is ‘‘inconclusive’’ and did not prove that withdrawing statins was safe.
Real-World Experience with Targeted Therapy for the Treatment of Anaplastic Thyroid Carcinoma.

BACKGROUND Patients with anaplastic thyroid cancer (ATC) have a dismal prognosis, despite systemic cytotoxic chemotherapy. The objective of this study was to investigate the efficacy and safety of targeted therapy in ATC patients when used outside of a clinical trial. METHODS This is a retrospective review from April 2015 to May 2016 at a single academic institution where 16 ATC patients receiving targeted therapy outside of a clinical trial were studied. Ten patients (eight BRAF wild type and two BRAFV600E mutant tumors) were started on lenvatinib, and six with BRAFV600E-mutated tumors received a combination of dabrafenib plus trametinib. Best response evaluated by RECIST v1.1, progression-free survival, and overall survival were determined. Adverse events were evaluated for safety. RESULTS The majority of patients (63%) were men, and all had distant metastases or radiation-resistant primary disease at the time of treatment. In the entire cohort, 6/16 (38%) had a partial response, 6/16 (38%) had stable disease, and 2/16 (12%) had progressive disease. Two (12%) patients died before restaging. Median follow-up time was 11.8 months. Median progression-free survival was 3.7 months [confidence interval 1.8-7.6] in the entire cohort, 2.7 months for lenvatinib, and 5.2 months for dabrafenib plus trametinib. Median OS was 6.3 months [confidence interval 1.8-7.6] for the entire cohort, 3.9 months for lenvatinib, and 9.3 months for dabrafenib plus trametinib. Adverse events were as expected and manageable. CONCLUSIONS Targeted therapies, lenvatinib, and dabrafenib plus trametinib (for BRAFV600E mutants) may provide clinical benefit in ATC patients who are unable to participate in clinical trials, and toxicities are manageable.
Engagement recognition by a latent character model based on multimodal listener behaviors in spoken dialogue

Engagement represents how much a user is interested in and willing to continue the current dialogue. Engagement recognition will provide an important clue for dialogue systems to generate adaptive behaviors for the user. This paper addresses engagement recognition based on multimodal listener behaviors of backchannels, laughing, head nodding, and eye gaze. In the annotation of engagement, the ground-truth data often differs from one annotator to another due to the subjectivity of the perception of engagement. To deal with this, we assume that each annotator has a latent character that affects his/her perception of engagement. We propose a hierarchical Bayesian model that estimates both engagement and the character of each annotator as latent variables. Furthermore, we integrate the engagement recognition model with automatic detection of the listener behaviors to realize online engagement recognition. Experimental results show that the proposed model improves recognition accuracy compared with other methods which do not consider the character such as majority voting. We also achieve online engagement recognition without degrading accuracy.
Treating Hypertension During Breastfeeding.

More nursing mothers might be receiving antihypertensive drugs under the new, stricter hypertension guidelines. The information on antihypertensive drugs during lactation is quite variable, with some drugs well established as acceptable and others with no human lactation information at all. This column reviews the various options for treating hypertension. Further study details and references can be found in the corresponding drug records in LactMed .
A comparison of APACHE II, BISAP, Ranson’s score and modified CTSI in predicting the severity of acute pancreatitis based on the 2012 revised Atlanta Classification

Objective Our aim was to prospectively compare the Accuracy of Acute Physiology and Chronic Health Evaluation (APACHE) II, Bedside Index of Severity in Acute Pancreatitis (BISAP), Ranson's score and modified Computed Tomography Severity Index (CTSI) in predicting the severity of acute pancreatitis based on Atlanta 2012 definitions in a tertiary care hospital in northern India. Methods Fifty patients with acute pancreatitis admitted to our hospital during the period of March 2015 to September 2016 were included in the study. APACHE II, BISAP and Ranson's score were calculated for all the cases. Modified CTSI was also determined based on a pancreatic protocol contrast enhanced computerized tomography (CT). Optimal cut-offs for these scoring systems and the area under the curve (AUC) were evaluated based on the receiver operating characteristics (ROC) curve and these scoring systems were compared prospectively. Results Of the 50 cases, 14 were graded as severe acute pancreatitis. Pancreatic necrosis was present in 15 patients, while 14 developed persistent organ failure and 14 needed intensive care unit (ICU) admission. The AUC for modified CTSI was consistently the highest for predicting severe acute pancreatitis (0.919), pancreatic necrosis (0.993), organ failure (0.893) and ICU admission (0.993). APACHE II was the second most accurate in predicting severe acute pancreatitis (AUC 0.834) and organ failure (0.831). APACHE II had a high sensitivity for predicting pancreatic necrosis (93.33%), organ failure (92.86%) and ICU admission (92.31%), and also had a high negative predictive value for predicting pancreatic necrosis (96.15%), organ failure (96.15%) and ICU admission (95.83%). Conclusion APACHE II is a useful prognostic scoring system for predicting the severity of acute pancreatitis and can be a crucial aid in determining the group of patients that have a high chance of need for tertiary care during the course of their illness and therefore need early resuscitation and prompt referral, especially in resource-limited developing countries.
A Random-allocation Graded Dose-Response Study of Norepinephrine and Phenylephrine for Treating Hypotension during Spinal Anesthesia for Cesarean Delivery.

BACKGROUND Norepinephrine has been investigated as a potential alterative to phenylephrine for maintaining blood pressure during spinal anesthesia for cesarean delivery with the advantage of less depression of maternal heart rate and cardiac output. However, the relative potencies of these two vasopressors have not been fully determined in this context. METHODS In a random-allocation, graded dose-response study, 180 healthy patients undergoing spinal anesthesia for elective cesarean delivery received a single bolus of norepinephrine in one of six different doses ranging from 4 to 12 µg or phenylephrine in one of six different doses ranging from 60 to 200 µg to treat the first episode of hypotension. The magnitude of response was measured as the percentage of full restoration of systolic blood pressure to the baseline value. Dose-response analysis was performed using nonlinear regression to derive four-parameter logistic dose-response curves, which were compared to determine relative potency. RESULTS Data were analyzed for 180 patients. The estimated ED50 values (dose giving a 50% response) were norepinephrine 10 µg (95% CI, 6 to 17 µg) and phenylephrine 137 µg (95% CI, 79 to 236 µg). The estimated relative potency ratio for the two drugs was 13.1 µg (95% CI, 10.4 to 15.8 µg). CONCLUSIONS Comparative dose-response analysis was completed for norepinephrine and phenylephrine given as a bolus to treat the first episode of hypotension in patients undergoing spinal anesthesia for cesarean delivery. The estimated dose equivalent to phenylephrine 100 µg was norepinephrine 8 µg (95% CI, 6 to 10 µg). These results may be useful to inform the design of future comparative studies.
Impact of acute health shocks on cigarette consumption: A combined DiD-matching strategy to address endogeneity issues in the French Gazel panel data

This paper investigates the relationship between an acute health shock, namely the first onset of an accident requiring medical care, and cigarette consumption, using the French Gazel panel data. To identify the causal effect of such shocks, we use a difference-in-differences approach combined with a propensity score. Results suggest that there is a significant effect running from the shock to the number of cigarettes smoked with impact duration of eight years after the shock. Individuals subject to such a shock smoke, on average, 2 cigarettes less (per week) than those not exposed to such a shock. Further, the findings show heterogeneous effects among smokers: heavy smokers are more likely to reduce tobacco consumption than occasional smokers.
Gender Bias in Pediatric Pain Assessment

Objective: Observer rating of pain is central to diagnosis and treatment in healthcare, especially in pediatrics. However, there are few studies examining potential biases in observer ratings of pediatric pain. Cohen et al. (2014) reported that adult participants rated a video of a child undergoing a needle stick as experiencing more pain when the child was described as a boy as compared to a girl, suggesting a possible gender bias. To confirm, clarify, and extend this finding, we conducted a replication experiment and follow-up study examining the role of explicit gender stereotypes in shaping such asymmetric judgments. Method: In an independent, pre-registered, direct replication and extension study with open data and materials (osf.io/6tj58), we showed participants the same video from Cohen et al. (2014), with the child described as a boy or a girl depending on condition. We then asked adults to rate how much pain the child experienced and displayed, how typical the child was in these respects, and how much they agreed with explicit gender stereotypes concerning pain response in boys versus girls. Results: Similar to Cohen et al. (2014), but with a larger and more demographically diverse sample, we found that the ‘boy’ was rated as experiencing more pain than the ‘girl’ despite identical clinical circumstances and identical pain behavior cross conditions. Controlling for explicit gender stereotypes eliminated the effect. Conclusions: Explicit gender stereotypes—e.g., that boys are more ‘stoic’ or girls are more emotive—may bias adult assessment of children’s pain.