Miracle-dz/UniFAR-FTUs huggingface dataset:
Long-term results after operative correction of vaginal aplasia.

OBJECTIVE We evaluated the long-term results after operative correction of vaginal aplasia with special interest in sexual and psychologic rehabilitation. STUDY DESIGN Forty-four patients who had undergone surgical construction of an artificial vagina took part in follow-up. The operative result was assessed by a gynecologic examination. A structured interview and five questionnaires allowed an evaluation of psychosexual rehabilitation. RESULTS The measured length of the vagina ranged between 3.5 and 15 cm. Unimpaired sexual intercourse could be ensured in a vagina with a minimum length of > or = 6 cm. The early onset of regular sexual intercourse played an important role for the long-term success of the operation. Patients were considered for an operation if they had a steady partner and hence could guarantee early and regular coitus. This concept was substantiated in our follow-up investigation. The increase in self-confidence thanks to sexual rehabilitation was striking. In a preoperative and postoperative survey 27 of the 44 patients displayed an impressive increase in self-confidence. However, infertility still posed a problem after successful surgical intervention. The overwhelming majority of patients were still depressed about infertility many years after the operation. One way to solve this problem may be adoption. CONCLUSIONS After surgery 82% of patients achieved a functional satisfactory postoperative result combined with overall psychosexual rehabilitation. An intensification of medical and psychologic care after discharge could further improve the long-term results. Special support is needed to solve the problem of infertility.
Center for Epidemiological Studies Depression Scale for Children

The Center for Epidemiological Studies Depression Scale for Children (CES-DC) is a 20-item self-report depression inventory with possible scores ranging from 0 to 60. Each response to an item is scored as follows: 0 = " Not At All " 1 = " A Little " 2 = " Some " 3 = " A Lot " However, items 4, 8, 12, and 16 are phrased positively, and thus are scored in the opposite order: 3 = " Not At All " 2 = " A Little " 1 = " Some " 0 = " A Lot " Higher CES-DC scores indicate increasing levels of depression. Weissman et al. (1980), the developers of the CES-DC, have used the cutoff score of 15 as being suggestive of depressive symptoms in children and adolescents. That is, scores over 15 can be indicative of significant levels of depressive symptoms. Remember that screening for depression can be complex and is only an initial step. Further evaluation is required for children and adolescents identified through a screening process. Further evaluation is also warranted for children or adolescents who exhibit depressive symptoms but who do not screen positive.
Myasthenia gravis in pregnancy: Experience of a portuguese center

Introduction: We evaluated the clinical course during pregnancy and neonatal outcomes of a cohort of Portuguese women with myasthenia gravis (MG). Methods: Retrospective study. Results: Twenty‐five patients with 30 pregnancies were included. Mean maternal age was 32.4 ± 4.1 years. Miscarriage rate was 6.7%, with delivery of 28 newborns. Deterioration in MG during pregnancy occurred in 43.3%, and 46.4% occurred at postpartum. Eighty percent were medicated with pyridostigmine, 43.3% with corticosteroids, and 40% with intravenous immunoglobulin. There were no maternal or neonatal deaths. Mean gestational time at delivery was 38.2 weeks. No cases of fetal growth restriction, preeclampsia, preterm delivery, or fetal demise were observed. Global cesarean rate was 64.3%. Two newborns developed transient neonatal myasthenia. Conclusions: A high rate of clinical worsening of MG in the mother was observed in this retrospective study, which highlights the importance of a multidisciplinary approach for avoiding maternal adverse outcomes. Muscle Nerve 54: 715–720, 2016
Rickettsia rickettsii Infection of Cultured Human Endothelial Cells Induces Heme Oxygenase 1 Expression

ABSTRACT Existing evidence suggests that oxidative insults and antioxidant defense mechanisms play a critical role in the host cell response during infection of endothelial cells by Rickettsia rickettsii, the causative agent of Rocky Mountain spotted fever. Heme oxygenase (HO), a rate-limiting enzyme in the pathway for heme catabolism, protects against oxidant damage in a variety of stress situations. Here, we report on the expression of the inducible and constitutive HO isozymes, HO-1 and HO-2, during R. rickettsii infection of endothelial cells. Steady-state levels for HO-1 mRNA were increased two- to threefold, as early as 4 h postinfection, whereas HO-2 mRNA was not affected. Induction of HO-1 mRNA was dependent on the dose of infection and occurred in a time-dependent manner, reaching maximal levels at 4 to 7 h. The increase in HO-1 mRNA occurred at the level of trancription as it was blocked by the transcriptional inhibitors, actinomycin D and α-amanitin. The eukaryotic protein synthesis inhibitor, cycloheximide, caused a >50% reduction in the infection-induced increase in HO-1 mRNA level, suggesting its dependence on de novo protein synthesis of host cell. The uptake of viable organisms appeared to be necessary, since inactivation of R. rickettsii by heat or formalin fixation, or incubation of cells with cytochalasin B to prevent entry resulted in marked inhibition of HO-1 response. N-Acetyl-l-cysteine, a known oxidant scavenger, inhibited the HO-1 induction by R. rickettsii. Finally, Western analysis with a specific monoclonal antibody revealed higher levels of HO-1 protein (∼32 kDa), confirming that changes in HO-1 mRNA levels were followed by increases in the levels of protein. The findings indicate that R. rickettsii infection induces HO-1 expression in host endothelial cells and suggest an important role for this enzyme in cellular response to infection, possibly by serving a protective function against oxidative injury.
Radiation‐induced xerostomia in patients with head and neck cancer

A dry mouth or xerostomia is one of the most common complications during and after radiotherapy for head and neck cancer, because irreparable damage is caused to the salivary glands, which are included in the radiation fields. Xerostomia not only significantly impairs the quality of life of potentially cured cancer patients, it may also lead to severe and long‐term oral disorders. Because management of xerostomia is rarely effective, prevention is paramount. Several strategies have been developed to avoid radiation‐induced salivary dysfunction without compromising definitive oncologic treatment. These include salivary gland‐sparing radiation techniques, such as 3‐dimensional conformal or intensity‐modulated radiotherapy, concomitant cytoprotectants, and surgical salivary gland transfer. However, these preventive approaches are not applicable to all patients, and comprehensive scientific research that incorporates new biological insights is warranted to optimize the therapeutic index of radiotherapy for head and neck cancer. Cancer 2006. © 2006 American Cancer Society.
Adjudicating neurocognitive endophenotypes for schizophrenia

Although genetic influences on schizophrenia are well established, localization of the genes responsible for this illness has proven extremely difficult. Given evidence that genes predisposing to schizophrenia may be transmitted without expression of the clinical phenotype, efforts have focused on developing endophenotypes. While several neuropsychological measures have been proposed to be endophenotypes, few studies have systematically assessed batteries of neurocognitive tests to determine which tests are most sensitive to liability for the illness. Two hundred sixty‐nine Latino individuals were administered a standard neuropsychological battery. Two hundred fourteen of these were members of families with at least two siblings diagnosed with schizophrenia or schizoaffective disorder. The remaining were community controls without history of major psychiatric illness. Neurocognitive measures found to be heritable were entered into analyses designed to determine which tests covary with the degree of genetic relationship to affected individuals. Although five measures were found to uniquely model genetic liability for schizophrenia, digit symbol coding was the most sensitive. To assess the specificity of these endophenotypes, performance on these measures were compared to family members with bipolar and unipolar affective disorders. These markers clearly distinguished between individuals with psychotic illnesses and those with major depression. As measures contributed uniquely to discriminate individuals at varying risk for schizophrenia, our findings imply multiple independently inherited elements to the liability for the illness. We present a practical model for adjudicating endophenotypes and determining which measures are best suited for use in linkage analyses. © 2006 Wiley‐Liss, Inc.
Primary angioplasty in ST-elevation myocardial infarction due to unprotected left-main coronary disease in a high-volume catheterization center without on-site surgery facilities: immediate and medium-term outcome: the STEMI-Placet Registry.

BACKGROUND Very few data have been published for ST-elevation myocardial infarction (STEMI) caused by unprotected left main coronary artery (ULMCA) and very little is known about the results in this subgroup of patients in a hospital with high-volume catheterization laboratories (cath labs) without on-site cardiosurgery. METHODS AND RESULTS From January 2004 to December 2009, a total of 38 patients with evolving STEMI and ULMCA as the culprit lesion treated with primary angioplasty were enrolled in our registry. Despite dramatic clinical presentation (73.7% cardiogenic shock, 15.8% cardiac arrest and resuscitation maneuvers, 81.6% additive EuroSCORE >13, and 89.5% distal bifurcation involvement), angiographic success was obtained in 84.2% and final TIMI 3 flow was achieved in 34 (89.5%), while target lesion failure occurred in 47.4% (mostly [42.1%] during the in-hospital phase). Most of the patients discharged from hospital had no events at follow-up (47.4%), and notably no target lesion revascularization was required during the follow-up phase. CONCLUSIONS Primary angioplasty in patients presenting with ULMCA as the culprit lesion in a STEMI setting appears to be technically feasible and a good alternative to surgical revascularization. Mortality in this group of patients tends to be high, but lower than mortality of untreated patients; the majority of events are concentrated during the in-hospital phase. Procedural delay related to activation of operator's staff in off-duty hours doesn't correlate with a worse prognosis.
Corporate Governance and Disclosures on the Transition to International Financial Reporting Standards

For reporting periods ending on or after 30 June 2004, Australian companies were required to disclose the expected impact of applying Australian equivalents of International Financial Reporting Standards effective from 1 January 2005. The objective of this paper is to examine the association between the level of disclosure and corporate governance quality. Using a sample of listed companies with 30 June balance dates, we find that the quantity of disclosure was positively related to some aspects of superior corporate governance, such as the frequency of board and audit committee meetings and the choice of auditor.
Cytotoxicity and genotoxicity of intravitreal adalimumab administration in rabbit retinal cells.

PURPOSE To assess the cytotoxicity and genotoxicity of intravitreal adalimumab treatment in an animal experimental model using cytological and molecular techniques. METHODS Eighteen rabbits were randomly assigned to three groups: control, adalimumab treatment, and placebo. Cytotoxicity on retinal cells was evaluated using flow cytometry assays to determine the level of apoptosis and necrosis. Genotoxicity was evaluated by comet assays to assess DNA damage, and quantitative real-time polymerase chain reaction (qPCR) was used to evaluate expression of apoptosis-inducing caspases (8 and 3). RESULTS No cytotoxicity or genotoxicity was observed in any of the two treatment groups (adalimumab and placebo) following intravitreal administration compared with the control group. Flow cytometry analysis revealed that more than 90% of the cells were viable, and only a low proportion of retinal cells presented apoptotic (~10%) or necrotic (<1%) activity across all groups. Molecular damage was also low with a maximum of 6.4% DNA degradation observed in the comet assays. In addition, no increase in gene expression of apoptosis-inducing caspases was observed on retinal cells by qPCR in both the adalimumab and placebo groups compared with the control group. CONCLUSION The use of adalimumab resulted in no detectable cytotoxicity or genotoxicity on retinal cells for up to 60 days upon administration. These results therefore indicate that adalimumab may be a safe option for intravitreal application to treat ocular inflammatory diseases in which TNF-α is involved.
Off-farm Labor Allocation, Income, and Food Consumption among Rural Farm Households in Transitional Albania

Abstract Purpose We analyze the food security implications of off-farm labor reallocation decisions of rural farm households in transitional Albania. We accomplish this by examining local and nonlocal off-farm incomes for at-home food consumption expenditures. Methodology/approach An instrumental variable approach is employed to correct for endogeneity and censorship biases of off-farm income variables in a two-stage estimation of the food consumption expenditures. Findings We find that local off-farm income exerts a positive and significant effect on per capita food consumption expenditures of farm households, while private remittances from nonlocal off-farm income has the opposite effect on food consumption expenditures. In terms of regional heterogeneity, we discover that the mountain region spends significantly less on annual per capita food consumption compared to the central region. This confirms anecdotal evidence that food and nutrition insecurity in rural Albania is predominant in the mountain region. Social implications Our findings suggest the need for policy makers to promote a development agenda that enables farm households to exploit the synergies among the various income-generating activities in the rural economy. This spectrum of income-generating activities forms complex livelihood strategies adopted by rural farm households to improve and maintain their food security. Originality/value We distinguish between local and nonlocal sources of off-farm income. Knowing which off-farm income source(s) has the largest impact on household welfare through improved food security status should be of interest to policy makers.
Evaluation of two iterative techniques for reducing metal artifacts in computed tomography.

PURPOSE To evaluate two methods for reducing metal artifacts in computed tomography (CT)--the metal deletion technique (MDT) and the selective algebraic reconstruction technique (SART)--and compare these methods with filtered back projection (FBP) and linear interpolation (LI). MATERIALS AND METHODS The institutional review board approved this retrospective HIPAA-compliant study; informed patient consent was waived. Simulated projection data were calculated for a phantom that contained water, soft tissue, bone, and iron. Clinical projection data were obtained retrospectively from 11 consecutively identified CT scans with metal streak artifacts, with a total of 178 sections containing metal. Each scan was reconstructed using FBP, LI, SART, and MDT. The simulated scans were evaluated quantitatively by calculating the average error in Hounsfield units for each pixel compared with the original phantom. Two radiologists who were blinded to the reconstruction algorithms used qualitatively evaluated the clinical scans, ranking the overall severity of artifacts for each algorithm. P values for comparisons of the image quality ranks were calculated from the binomial distribution. RESULTS The simulations showed that MDT reduces artifacts due to photon starvation, beam hardening, and motion and does not introduce new streaks between metal and bone. MDT had the lowest average error (76% less than FBP, 42% less than LI, 17% less than SART). Blinded comparison of the clinical scans revealed that MDT had the best image quality 100% of the time (95% confidence interval: 72%, 100%). LI had the second best image quality, and SART and FBP had the worst image quality. On images from two CT scans, as compared with images generated by the scanner, MDT revealed information of potential clinical importance. CONCLUSION For a wide range of scans, MDT yields reduced metal streak artifacts and better-quality images than does FBP, LI, or SART. SUPPLEMENTAL MATERIAL http://radiology.rsna. org/lookup/suppl/doi:10.1148/radiol.11101782/-/DC1.
Have financial statements lost their relevance? Empirical evidence from the frontier market of Kuwait

Purpose - – Anecdotal concerns expressed regarding developed capital markets suggest that the information provided in financial statements has lost its value relevance to equity holders over time. The purpose of this paper is to investigate the issue from the perspective of Kuwait, which is a frontier market. Design/methodology/approach - – Consistent with prior research, the design employs the price regression model. A total of 2,490 observations were collected from all firms listed on the Kuwait Stock Exchange (KSE) over a period of 21 years (1994-2014). Findings - – Although this study documents a notable decline in both the value relevance of earnings and book value for equity holders over this period, the results suggest that the decline in the value relevance of earnings was deeper and more pronounced than that of book value. Practical implications - – Because a fundamental prerequisite for the value relevance of accounting information is the quality of the financial reporting environment, the results are useful for regulators because they provide an assessment of the effectiveness of the current financial reporting environment. The results highlight the need for improvements because higher-quality information helps equity holders to determine value more precisely. As the timely dissemination of financial statements is an essential ingredient contributing to the relevance of financial statements, a direct implication of the study’s findings for the management of KSE companies is that timely reporting of financial statements may mitigate the observed decline of the value relevance of financial statements produced by KSE companies. Originality/value - – This study contributes to the capital market research regarding changes in the value relevance of financial statement information through an empirical examination of a frontier capital market.
Peritransplant treatment with cobalt protoporphyrin attenuates chronic renal allograft rejection

Allogen‐independent injury contributes to chronic rejection in renal allografts and heme oxygenase‐1 (HO‐1) has been shown to be protective in a number of settings. This study evaluated the effect of renal allograft recipient HO‐1 up‐regulation on chronic rejection in a rat model. Rat (F344 to Lewis) renal transplantation recipients were grouped: (i) cyclosporine (CsA) alone (0.75 mg/kg s.c. × 10 day; n = 5); (ii) CsA + low dose cobalt protoporphyrin (CoPP) an HO‐1 inducer (0.5 mg/kg i.p. on days −5,0,5; n = 13) and (iii) CsA + high dose CoPP (5.0 mg/kg i.p. on days −5,0,5; n = 8). Renal function was assessed by serum creatinine levels on day 140. Histopathologic changes in allografts were graded. Morphometric analyses performed to objectively quantify the vascular changes and glomerulosclerosis. HO‐1 expression quantified by Western blot and both HO‐1 and endothelin (ET‐1) localized using immunohistochemistry. Recipients treated with CsA + high dose CoPP had significantly decreased cortical scarring, vascular hyalinization and intimal thickness. They also had a significant, dose dependant, reduction in luminal obliteration and glomerulosclerosis by morphometric analyses. This freedom from chronic rejection in recipients treated with CoPP translated into quiescent grafts at postoperative day 140 with immunostaining and Western blot demonstrating decreased level of HO‐1 versus controls (P = 0.012). In summary, the peritransplant up‐regulation of HO‐1 in renal allograft recipients significantly attenuates chronic rejection in rat renal allografts by inhibiting transplant vasculopathy.
Ubiquitous production of macrophage migration inhibitory factor by human gastric and intestinal epithelium.

BACKGROUND & AIMS Macrophage migration inhibitory factor (MIF) inhibits macrophage migration and has pleiotropic activities on immune and inflammatory responses, cell growth, and glucose metabolism. MIF is produced by T cells, macrophages, and endothelial cells. Because intestinal epithelial cells produce mediators important for regulating mucosal immune and inflammatory responses, we sought to determine if these cells produce MIF. METHODS MIF expression was determined by immunostaining of human intestinal mucosa, intestinal xenografts, and cultured cells. MIF protein levels were quantitated by enzyme-linked immunosorbent assay and immunoblot analysis, messenger RNA was assessed by real-time reverse-transcription polymerase chain reaction, and functional activity was assessed by enzymatic and migration assays. RESULTS MIF was abundantly expressed in vivo in gastric, small intestinal, and colonic epithelium and in epithelium lining human intestinal xenografts. MIF was also constitutively expressed at the messenger RNA and protein level by several cultured colon and gastric epithelial cell lines, and its expression in those cells was not up-regulated by the proinflammatory cytokines interleukin 1alpha, tumor necrosis factor alpha, or interferon gamma. Epithelial MIF from cultured cells was released predominantly from the apical side after Salmonella infection, had tautomerase activity, and arrested macrophage migration. CONCLUSIONS Human intestinal epithelial cells are a major source of MIF, a molecule that can regulate macrophage migration, inflammation, and cell metabolism.
Comparing early oral feeding with traditional oral feeding in upper gastrointestinal surgery.

BACKGROUND/AIMS Due to the lack of interest in using early oral feeding and the need for a trial study in this regard, this study aimed to compare the outcome of early oral feeding and traditional oral feeding in patients with upper gastrointestinal surgery. METHODS Fifty-two patients who underwent upper gastrointestinal surgery were randomly assigned into two groups in a consecutive manner as either the early oral feeding group or traditional oral feeding group. Tolerance of oral feeding, ileus, nausea and vomiting, post-operative stay, and complications were recorded. RESULTS Tolerance of oral feeding for the two groups was 24 (92.3%) in the early oral feeding group and 21 (91.3%) in the traditional oral feeding group (p=0.89). The post-operative hospital stays were 5.62 and 8.04 days in the early oral feeding and traditional oral feeding groups, respectively (p<0.0001). There were significant differences between the two groups in terms of the time of the first gas passing/defecation, the post-operative hospital stays, starting time of oral feeding, and satisfaction regarding early nasogastric tube removal. CONCLUSIONS The results of this study show that early oral feeding is a safer and more cost-effective procedure in upper gastrointestinal surgery.