Miracle-dz/UniFAR-FTUs huggingface dataset:
Nonpalpable Thyroid Carcinoma: Clinical Controversies on Preoperative Selection

This article emphasizes some controversies concerning the preoperative selection of nonpalpable thyroid tumors. The prevalence of occult thyroid carcinoma in surgical series (1.8–10%) is not higher than in autopsy thyroid series (2.7–24%). The prevalence of occult thyroid carcinoma in thyroid glands examined in the same institution by ultrasound, for a clinical thyroid abnormality or for investigation of other neck structures without clinically evident or suspected thyroid disease, varies from 3% to 8% and is very similar independent of the fact that a thyroid abnormality is or is not the indication for ultrasonography. These data suggest that the presence of a thyroid disease is not a risk factor for harboring an occult thyroid carcinoma (except for C-cell hyperplasia in the rare case of MEN 2 syndromes). As it is not cost effective to examine all the nonpalpable lesions with fine-needle aspiration (FNA) guided by ultrasounds, it is necessary to define to which extent ultrasound is useful in selecting those lesions to be examined cytologically by FNA. The use of ultrasound to select these lesions is very controversial. Ultrasound-guided cytologic diagnosis of nonpalpable nodules is not as accurate as in the case of palpable nodules. Sampling of material adequate for cytologic analysis depends on the lesion size; it is 64% for a 0.7-cm lesion and it increases to 86.7% for a mean size of 1.1 cm. For the diagnosis of occult thyroid carcinomas (≤1 cm), sensitivity is 35.8% and false-negative results are 49.3%. Nonpalpable nodules with a size of 1.5 cm represent an absolute indication to perform an ultrasound-guided FNA because this is the size limit for dividing thyroid nodules in probably innocuous or potentially dangerous categories and because the cytologic diagnosis of nodules of this size is sufficiently reliable. For the smaller incidentally discovered thyroid nodules following ultrasound, physicians should discuss with the patient whether and when to perform an ultrasound-guided FNA considering the patient’s data (risk factors, age, health state, etc.), the natural history of a small thyroid carcinoma, as well as the accuracy of ultrasound and ultrasound-guided FNA in the specific institution.
Immune responses to polyethylenimine-mannose-delivered plasmid DNA encoding a Fasciola gigantica fatty acid binding protein in mice

Abstract Fasciola gigantica fatty acid binding protein (FABP) was evaluated for evoking an immune response in mice, by delivering the gene coding for this protein with mannosylated-polyethylenimine (PEI) to peritoneal cells. Mice were immunized with 50 μg recombinant plasmid DNA (Group I) or DNA-PEI-mannose (a 22 kDa linear cationic polymer with mannose ligand) (Group II) via the intraperitoneal route. Antibody studies showed no significant humoral immune response evoked to this DNA immunization with either PEI-mannose-delivered or naked DNA. However, on protein boosting of these DNA-primed mice there was a significant enhancement of antibody titre. Flow cytometric bead array was used to measure quantitites of interleukin (IL)-2, IL-4, IL-5, interferon-γ (IFN-γ) and tumour necrosis factor (TNF) cytokines. Overexpression of T-helper 1 (Th1) cytokines such as IFN-γ and TNF, with a lower but significant expression of the T-helper 2 (Th2) cytokine IL-5 was detected. Gene delivery using polyethylenimine-mannose ligand showed significant expression of IFN-γ and TNF (P < 0.05), but no significant difference in IL-2, IL-4 and IL-5 (P>0.05) cytokine expression was observed between naked-DNA- and mannosylated PEI-DNA-delivered mice. Naked- or PEI-delivered-DNA immunization produced insignificant levels of IL-2 and IL-4 (P>0.05) cytokines in both groups of mice.
What influences acceptability and engagement with a high intensity exercise programme for people with stroke? A qualitative descriptive study.

BACKGROUND Intensity refers to the amount of effort or rate of work undertaken during exercise. People receiving rehabilitation after stroke frequently do not reach the moderate to high intensity exercise recommended to maximise gains. OBJECTIVE To explore the factors that influence the acceptability of, and engagement with, a high intensity group-based exercise programme for people with stroke. METHODS This qualitative descriptive study included 14 people with stroke who had completed a 12-week, high intensity group-based exercise rehabilitation programme. Semi-structured interviews were used to explore the acceptability of high intensity exercise and the barriers and facilitators to engagement. Interviews were recorded, transcribed and analysed using qualitative content analysis. RESULTS The participants found high intensity exercise rehabilitation acceptable despite describing the exercise intensity as hard and reporting post-exercise fatigue. Participants accepted the fatigue as a normal response to exercise, and it did not appear to negatively influence engagement. The ease with which an individual engaged in high intensity exercise rehabilitation appeared to be mediated by inter-related factors, including: seeing progress, sourcing motivation, working hard, the people involved and the fit with the person and their life. Participants directly related the intensity of their effort to the gains that they made. CONCLUSIONS In this study, people with stroke viewed training at higher intensities as a facilitator, not a barrier, to engagement in exercise rehabilitation. The findings may challenge assumptions about the influence of exercise intensity on engagement.
From Competition to Collaboration in Public Service Delivery: A New Agenda for Research

Competition was one of the guiding threads of public policy under the Conservative Governments of the 1980s and 1990s. But whereas the Conservatives looked to the market primarily for the disciplining and economizing effects of competition, the Labour Government sees the market as a source of innovation and improvement. Following a brief description of these different perspectives, this paper identifies three avenues deserving of further inquiry: the costs and benefits of high trust interorganizational relationships; the way in which partnerships combine the competencies of different sectors; and finally, the extent to which the new partnerships transform public service delivery.
Perceptions of electoral fairness : public behaviour and institutional design compared across 80 countries

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Citrus tristeza virus p23: a unique protein mediating key virus–host interactions

The large RNA genome of Citrus tristeza virus (CTV; ca. 20 kb) contains 12 open reading frames, with the 3′-terminal one corresponding to a protein of 209 amino acids (p23) that is expressed from an abundant subgenomic RNA. p23, an RNA-binding protein with a putative zinc-finger domain and some basic motifs, is unique to CTV because no homologs have been found in other closteroviruses, including the type species of the genus Beet yellows virus (despite both viruses having many homologous genes). Consequently, p23 might have evolved for the specific interaction of CTV with its citrus hosts. From a functional perspective p23 has been involved in many roles: (i) regulation of the asymmetrical accumulation of CTV RNA strands, (ii) induction of the seedling yellows syndrome in sour orange and grapefruit, (iii) intracellular suppression of RNA silencing, (iv) elicitation of CTV-like symptoms when expressed ectopically as a transgene in several Citrus spp. , and (v) enhancement of systemic infection (and virus accumulation) in sour orange and CTV release from the phloem in p23-expressing transgenic sweet and sour orange. Moreover, transformation of Mexican lime with intron-hairpin constructs designed for the co-inactivation of p23 and the two other CTV silencing suppressors results in complete resistance against the homologous virus. From a cellular point of view, recent data indicate that p23 accumulates preferentially in the nucleolus, being the first closterovirus protein with such a subcellular localization, as well as in plasmodesmata. These major accumulation sites most likely determine some of the functional roles of p23.
Bacterial Adhesion to Protein-Coated Hydrogels

Extended wear soft contact lenses have been implicated in the increased occurrence of corneal bacterial infections. This research investigated the effects of polymer chemistry, water content, and pre-sorbed proteins upon the adherence of Pseudomonas aeruginosa to model hydrogels with chemistries similar to those of extended wear soft contact lenses. The hydrogels were exposed to washed suspensions of R aeruginosa in a laminar flow cell. Albumin, fibrinogen, desialylated fibrinogen, or mucin were deposited on the hydrogels before exposure to the bacteria. Results showed that with or without protein pre-exposure, bacterial adhesion decreased as water content increased. In the presence of the sorbed protein, the number of adherent bacteria increased by about 45%, and all four proteins caused similar increases in adhesion. Bacterial adhesion was not significantly influenced by the presence of sialic acid residues in the pre-sorbed protein.
Growth Performance and Economic Efficiency of Growing New Zealand White Rabbits Fed Different Levels of Crud Fiber by Using Corn Cob With and Without Enzyme Supplementation

A total of fifty weanling New Zealand White (NZW) rabbits that were five weeks old (800 g live weight on average) were randomly allocated into five groups of 10 rabbits each and were housed in individual cages. The groups were control (12% CF and 30.08 NDF), 14% CF without enzymes (30.69 NDF), 14% CF with enzymes (30.69 NDF), 16% CF without enzymes (31.76 NDF), 16% CF with enzymes (31.76 NDF) for groups 1, 2, 3, 4, and 5, respectively. All groups received pelleted diets ad libitum for 6 weeks. Daily feed intake was recorded and total feces were collected daily and weighed individually during four days for digestibility trial. live body weight (BW), daily weight gain (WG), feed intake, feed conversion ratio (FCR) were evaluated. Apparent digestibility of nutrients [crude protein (CP), Dry matter (DM), ash], carcass traits, and some blood serum constituents (glucose, total protein, albumin, AST, and ALT) were determined. Also, the economic efficacy of this study was determined. The results showed significant reduction (P
Post-prandial serum bile acid concentrations and ammonia tolerance in Maltese dogs with and without hepatic vascular anomalies.

Post-prandial serum bile acid concentrations were measured in 200 Maltese dogs in an attempt to identify those with subclinical portosystemic shunts. Five of these were later shown to have hepatic pathology or abnormal liver function. In the other 195 Maltese, bile acid concentrations ranged from 1 to 362 mumol.L-1 (mean +/- SD, 70 +/- 50 mumol.L-1; median, 65.0 mumol.L-1). Of these, 79% were above the reference range (0 to 31 mumol.L-1) established from 23 mixed-breed control dogs. It was therefore not possible to determine the prevalence of subclinical portosystemic shunts on the basis of bile acid determinations. Further investigation of liver function was performed to investigate why bile acid concentrations were increased in these dogs. Rectal ammonia tolerance tests were normal in 102 of 106 Maltese tested and liver samples (11 dogs) and plasma biochemistry profiles (9 dogs) demonstrated no significant hepatic disease or dysfunction. Of 2 Maltese with hyperammonaemia after administration of ammonium chloride, one had a large congenital portosystemic shunt that was confirmed at surgery. In the other there were no macroscopic portosystemic communications, but a liver biopsy showed histological changes consistent with microscopic portovascular dysplasia. Total serum bile acid concentrations were consistently lower when assessed by high-performance liquid chromatography than by an enzymatic spectrophotometric method. This discrepancy was substantially larger in Maltese than in control dogs, suggesting the presence of an additional reacting substance in the serum of Maltese dogs.
Three Essays on Corporate Governance

Three Essays on Corporate Governance Aazam Virani Doctor of Philosophy Graduate Department of Management Finance University of Toronto 2014 The roles of the market for corporate control and institutional investor monitoring as corporate governance mechanisms are studied. First, I examine agreements that address the interests of stakeholders of takeover targets, particularly the management and board, which are termed “social issues” and are frequently negotiated during mergers. I find that the inclusion of social issues comes at the cost of lower target shareholder returns. Furthermore, social issues are particularly costly for shareholders of targets whose management has enhanced negotiating power, and are also associated with poorer post-merger performance. Social issues therefore reflect a trade-off between shareholder and managerial interests and they are an important friction arising during changes in control. Second, we study a feature of takeovers which permits acquirers to walk away at the cost of paying a “reverse termination fee” to the target. We model a merger contract with this feature as a real call option on the assets of the target firm, which ensures the merger terminates whenever completion is sub-optimal. We find that this feature is more common when there is a higher risk that the target’s value to the acquirer will fall below its stand-alone value before deal completion, and that the size of the fee is driven by option-like characteristics of mergers. The risk that a change in control decreases value may therefore be mitigated by a real option contract. Last, we examine the ability of institutional investors to improve governance by acting collectively. We show that private and organized engagements with firms by a coalition of Canadian institutional investors make the firms more likely to improve shareholder democracy and compensation structure and disclosure. We find that the coalition’s influence is further broadened through director interlocks and the publication of governance scores, although there are limits to its influence. Institutional investors can therefore overcome coordination costs and act collectively to improve governance at the firm and market levels. Overall, the analysis indicates that frictions which impede the effectiveness of the market for corporate control and institutional investor monitoring as corporate governance mechanisms may be overcome by investor power, contracting and coordinated action.
Tyrosine kinases, drugs, and Shigella flexneri dissemination

Shigella flexneri is an enteropathogenic bacterium responsible for approximately 100 million cases of severe dysentery each year. S. flexneri colonization of the human colonic epithelium is supported by direct spread from cell to cell, which relies on actin-based motility. We have recently uncovered that, in intestinal epithelial cells, S. flexneri actin-based motility is regulated by the Bruton’s tyrosine kinase (Btk). Consequently, treatment with Ibrutinib, a specific Btk inhibitor currently used in the treatment of B-cell malignancies, effectively impaired S. flexneri spread from cell to cell. Thus, therapeutic intervention capitalizing on drugs interfering with host factors supporting the infection process may represent an effective alternative to treatments with antimicrobial compounds.
Pelvic Floor Disorders, Diabetes, and Obesity in Women

OBJECTIVE—We examined associations between obesity and diabetes and female pelvic floor disorders (PFDs), stress urinary incontinence (SUI), overactive bladder (OAB), and anal incontinence (AI) in community-dwelling women. RESEARCH DESIGN AND METHODS—Women were screened for PFD using a validated mailed survey. Diabetes status, glycemic control, and diabetes treatment were extracted from clinical databases, while other risk factors for PFDs were obtained through self-report. Women were categorized hierarchically as nonobese/nondiabetic (reference), nonobese/diabetic, obese/nondiabetic, and obese/diabetic. RESULTS—Of 3,962 women, 393 (10%) had diabetes. In unadjusted analyses, women with diabetes and women who were obese had greater odds of having PFDs. Among women with diabetes, being obese was associated with SUI and OAB. After adjusting for confounders, we found that obese/diabetic women were at the highest likelihood of having SUI (odds ratio 3.67 [95% CI 2.48–5.43]) and AI (2.09 [1.48–2.97]). The odds of having OAB among obese women was the same for obese/diabetic women (2.97 [2.08–4.36]) and obese/nondiabetic women (2.93 [2.33–3.68]). Nonobese/diabetic women had higher odds of SUI (1.90 [1.15–3.11]) but did not differ significantly in their OAB (1.45 [0.88–2.38]) and AI (1.33 [0.89–2.00]) prevalence from nonobese/nondiabetic women. CONCLUSIONS—Given the impaired quality of life experienced by women with PFDs, health care providers should counsel women that obesity and diabetes may be independent modifiable risk factors for PFDs.
Cell proliferation, apoptosis, and apoptosis inhibition in malignant transformation of sinonasal inverted papilloma

Conclusion. Increasing cell proliferation seems to be a very important factor in the development of inverted papilloma (IP). Apoptosis that was increased but weakly inhibited by Bcl-2 did not cause imbalance in the cell proliferation. Further increased cell proliferation in IP with dysplasia was an important mechanism of growth in dysplastic areas. Objectives. The purpose of this study was to compare cell proliferation, apoptosis, and apoptosis inhibition by Bcl-2 in IP. Patients and methods. Cell proliferation and apoptosis inhibition were detected by immunohistochemical staining with monoclonal antibodies to Ki-67 and Bcl-2. Apoptosis was detected by the transferase-mediated dUTP nick end-labeling (TUNEL) method. Results. As regards the Ki-67 index (KI), a significant increase was observed in IP with severe dysplasia, IP with carcinoma and invasive squamous cell carcinoma (SCC) compared with EP and IP with mild and moderate dysplasia. For the apoptosis index (AI), a significant increase was observed in IP with mild and moderate dysplasia compared with IP with carcinoma, invasive SCC and EP. For the Bcl-2 index (BI), a significant increase in expression was observed in IP with severe dysplasia and carcinoma and invasive SCC compared with control, EP and IP with mild dysplasia. Among IP, the KI (average 18.2%) was much higher than the AI (6.4%) and BI (4.1%).
Diffusion-weighted imaging of the appendicular skeleton with a non-Carr-Purcell-Meiboom-Gill single-shot fast spin-echo sequence.

OBJECTIVE The objective of our study was to prospectively evaluate the signal-to-noise ratio (SNR) improvement in diffusion-weighted imaging (DWI) of the appendicular skeleton with the use of a newly developed non-Carr-Purcell-Meiboom-Gill (non-CPMG) single-shot fast spin-echo (SSFSE) sequence and to evaluate its effect on apparent diffusion coefficient (ADC) measurements. SUBJECTS AND METHODS DWI of the bone was performed in 32 patients with an echo-planar imaging (EPI)-based sequence followed by a non-CPMG SSFSE technique. SNR and ADC values were measured over a lesion-free right femoral head. A score was assigned for each set of images to assess image quality. When a bone lesion was present, contrast-to-noise ratio (CNR) and ADC were also measured. Paired Student's t tests were used for statistical analysis. RESULTS The mean (+/- SD) SNR values were 9.89 +/- 2.20 and 81.68 +/- 4.87 for EPI and non-CPMG SSFSE DWI, respectively. SNR values associated with the non-CPMG SSFSE technique were found to be significantly higher than those measured with the EPI-based DWI technique (p < 0.01). Mean ADCs of the bone were 0.57 +/- 0.20 and 0.29 +/- 0.15 x 10(-3) mm2/s, respectively, for EPI and non-CPMG SSFSE DWI. Image quality scores were higher for the non-CPMG SSFSE DWI technique (p < 0.05) than for the EPI-based DWI technique. Overall lesion CNR was found to be higher in DWI performed with the non-CPMG SSFSE technique. CONCLUSION The non-CPMG SSFSE technique provides a significant improvement over the currently used EPI-based DWI technique and has the potential to be a powerful tool in imaging the appendicular skeleton.
Tumour size predicts long-term survival among women with lymph node-positive breast cancer.

BACKGROUND The benefit of early detection of breast cancer is assumed to be achieved primarily by identifying disease before it has spread beyond the breast. In support of early detection, the survival experience of women with breast cancer decreases as the mean size of the cancer increases. It is not clear if women with regional spread (node-positive breast cancer) benefit from early detection to the same extent that women with node-negative breast cancer do. METHODS A review was conducted of the survival experience of 1894 patients with invasive breast cancers 5.0 cm or less in size. Cases were divided into node-positive and node-negative, and tumours were categorized by size (0.1-1.0 cm, 1.1-2.0 cm, and 2.1-5.0 cm). After a mean follow-up of 9.9 years, 368 cancer-specific deaths had occurred in the cohort. The effect of tumour size on 15-year survival for subgroups of women with node-positive and node-negative breast cancer was estimated. RESULTS Tumour size was a strong predictor of 15-year survival in both the node-positive and node-negative cancer subgroups. A decline of 1.0 cm in size was associated with a reduction in 15-year mortality of 10.3% in the node-positive group and of 2.5% in the node-negative group. A decline of approximately 1.5 cm was associated with a reduction in mortality of 23.0% in the node-positive group and of 10.8% in the node-negative group. CONCLUSIONS The impact of decreasing tumour size on 15-year survival is much greater for women with node-positive than for women with node-negative breast cancers. Contrary to expectation, the benefit of screening is likely to be greater for women with relatively advanced breast cancer than for women with earlystage disease.