Miracle-dz/UniFAR-FTUs huggingface dataset:
Clinical Relevance of 18F-FDG PET and 18F-DOPA PET in Recurrent Medullary Thyroid Carcinoma

The transition from stable to progressive disease is unpredictable in patients with biochemical evidence of medullary thyroid carcinoma (MTC). Calcitonin and carcinoembryonic antigen (CEA) doubling times are currently the most reliable markers for progression, but for accurate determination, serial measurements, which need time, are required. We compared 18F-FDG PET and 18F-dihydroxyphenylanaline (18F-DOPA) PET with biochemical parameters and survival to assess whether these imaging modalities could be of value in detecting progressive disease. Methods: We evaluated the outcome of 18F-FDG PET or 18F-DOPA PET with calcitonin and CEA doubling times in 47 MTC patients. A subgroup of patients was included in the whole metabolic burden (WBMTB) analysis, with determination of standardized uptake values and number of lesions. WBMTB of 18F-DOPA PET and 18F-FDG PET was compared with biochemical parameters. Furthermore, survival was compared with 18F-DOPA PET or 18F-FDG PET positivity. Results: Doubling times were available for 38 of 40 patients undergoing 18F-FDG PET. There was a significant correlation with 18F-FDG PET positivity. Doubling times were less than 24 mo in 77% (n = 10/13) of 18F-FDG PET–positive patients, whereas 88% (n = 22/25) of 18F-FDG PET–negative patients had doubling times greater than 24 mo (P < 0.001). Between doubling times and 18F-DOPA PET positivity, no significant correlation existed. 18F-DOPA PET detected significantly more lesions (75%, 56/75) than did 18F-FDG PET (47%, 35/75) in the 21 patients included in WBMTB analysis (P = 0.009). Calcitonin and CEA levels correlated significantly with WBMTB on 18F-DOPA PET, but doubling times did not. 18F-FDG PET positivity was a more important indicator for poor survival in patients for whom both scans were obtained. Conclusion: 18F-FDG PET is superior in detecting patients with biochemical progressive disease and identifying patients with poor survival. Although 18F-DOPA PET has less prognostic value, it can more accurately assess the extent of the disease in patients with residual MTC. Hence, both scans are informative about tumor localization and behavior. On the basis of these results, we designed a clinical flow diagram for general practice in detecting recurrent MTC.
Attendance of exercise referral schemes in the UK: A systematic review

Objective The aim of this review was to explore attendance of UK exercise referral schemes (ERS), who attends them, why participants drop out of schemes and to compare evaluations of existing ERS with randomised controlled trials (RCTs). Design Systematic review. Method A search of major databases was conducted to identify studies investigating ERS interventions that were based in primary care in the UK, reported attendance-related outcomes and were published in peer- reviewed journals. Results Five evaluations of existing ERS and four RCTs met the inclusion criteria. Method of participant recruitment was the only marked difference between the two types of study. In RCTs and evaluations, rates of referral uptake and attendance were varied but comparable. Attendance was generally poor; approximately eighty per cent of participants who took up referral dropped out before the end of programmes. More women than men took up referral (60 vs. 40 per cent) but there was no evidence of higher attendance in women. None of the participant characteristics reported were consistently associated with attendance. Most of the reasons for attrition and negative comments from participants related to practical problems associated with attending leisure facilities. Conclusion The present review highlighted a high level of attrition in ERS. However, poor measurement and reporting of attendance, and inadequate participant profiling, prevented us from identifying which sections of the population were most likely to attend or drop out. Adequate data collection regimens, beginning at the point of referral would enable us to learn whom exactly ERS are proving successful for.
Delivering Quality Care: The Roles and Future of Midwives in Southern California

The United States is ranked 27 th in the world for maternal mortality, yet spends twice as much on maternity care services as countries with better maternal health indicators. Stuck in a technocratic and physician-dominated maternity care system, the U.S. depends on expensive technologies to control birth out of fear of pain and litigation, costing Americans billions of dollars and depriving women of the opportunity to have a transformative birth experience. Through an analysis of the medicalization of birth and the current biomedical model in birth, in conjunction with open-ended interviews with 5 hospital midwives and 3 homebirth midwives, the benefits and challenges of incorporating a midwifery model of care into our maternity services are explored. The midwifery model emphasizes that birth is not pathology and that psychosocial factors play a large role in birth outcomes. Basing their practice on collaboration, education, and support, midwives empower women, avoid unnecessary interventions, and offer a lower cost and higher quality care alternative. The current monopoly of women’s health services by physicians is unsustainable. Incorporating midwives into the maternity care team could provide a sustainable alternative with the caliber of maternity care services that U.S. women and families deserve.
A hidden Markov model based intrusion detection system for wireless sensor networks

Wireless sensor network (WSN) technology is being increasingly used for data collection in critical infrastructures (CIs). This paper presents an intrusion detection system (IDS), which is able to protect a CI from attacks directed to its WSN-based parts. By providing accurate and timely detection of malicious activities, the proposed IDS solution ultimately results in a dramatic improvement in terms of protection, since opportunities are given for performing proper remediation/reconfiguration actions, which counter the attack and/or allow the system to tolerate it. The proposed solution has the important advantage of exploiting the high accuracy of hidden Markov models as an effective means of detecting malicious activities. We present the basic ideas, discuss the main implementation issues, and perform a preliminary experimental campaign, with respect to sinkhole attacks, one of the most serious attacks to WSNs.
In Vivo Visualization of MET Tumor Expression and Anticalin Biodistribution with the MET-Specific Anticalin 89Zr-PRS-110 PET Tracer

Anticalins are a novel class of biopharmaceuticals, displaying highly desirable attributes as imaging agents. The anticalin PRS-110 was rationally engineered to target the oncogene MET with high affinity and specificity. The aim of this study was to visualize MET expression and analyze biodistribution of 89Zr-labeled PRS-110 in human tumor–bearing mice. Methods: 89Zr-PRS-110 was generated. For biodistribution studies (96 h after injection of tracer) 10 μg of 89Zr-PRS-110 (with 0–490 μg of unlabeled PRS-110) were injected into BALB/c mice bearing high MET-expressing H441 non–small cell lung cancer xenografts. Further characterization with PET imaging was performed at 6, 24, 48, and 96 h after injection of 50 μg of 89Zr-PRS-110 into mice bearing H441, primary glioblastoma U87-MG (intermediate MET), or ovarian cancer A2780 (low MET) xenografts. Drug distribution was also analyzed ex vivo using fluorescently labeled PRS-110. Results: Biodistribution analyses showed a dose-dependent tumor uptake of 89Zr-PRS-110, with the highest fractional tumor uptake at 10 μg of 89Zr-PRS-110, with no unlabeled PRS-110. Small-animal PET imaging supported by biodistribution data revealed specific tumor uptake of 89Zr-PRS-110 in the MET-expressing H441 and U87-MG tumors whereas the MET-negative A2780 tumor model showed a lower uptake similar to a non-MET binder anticalin control. Tumor uptake increased up to 24 h after tracer injection and remained high, whereas uptake in other organs decreased over time. Ex vivo fluorescence revealed intracellular presence of PRS-110. Conclusion: 89Zr-PRS-110 specifically accumulates in MET-expressing tumors in a receptor density–dependent manner. PET imaging provides real-time noninvasive information about PRS-110 distribution and tumor accumulation in preclinical models.
Anemia and iron deficiency in rural Nepali pregnant women: Risk factors, effect of vitamin A supplementation and their association with birth outcomes

88 INTRODUCTION 90 SUBJECTS AND METHODS 91 Demographic, anthropometric, health and dietary assessment 91 Iron and vitamin A status assessment 92 Iron and vitamin A supplementation groups 93 Statistical analysis 94 Ethical consent 96 RESULTS 96 Correlation between Hb and retinol at baseline 97 Effect of supplementation on Hb 97 Effect of supplementation on sTfR 99 DISCUSSION 100 CONCLUSION 108 CHAPTER 5. MATERNAL HEMOGLOBIN CONCENTRATIONS AND RISK OF LOW BIRTH WEIGHT AND PRETERM DELIVERY IN RURAL NEPALI PREGNANT WOMEN 115 ABSTRACT 115 INTRODUCTION 117 SUBJECTS AND METHODS 118
11C-Acetate PET/CT for Metabolic Characterization of Multiple Myeloma: A Comparative Study with 18F-FDG PET/CT

We prospectively compared 11C-acetate with 18F-FDG in a PET/CT evaluation of multiple myeloma (MM), specifically on diagnostic accuracy, identification of high-risk patients, and monitoring of treatment response. Methods: Dual-tracer PET/CT was performed on 35 pathologically and clinically confirmed and untreated patients (26 with symptomatic MM, 5 with smoldering MM, and 4 with monoclonal gammopathy of unknown significance) and 20 individuals with normal marrow. Results: 11C-acetate showed significant incremental value over 18F-FDG (84.6% vs. 57.7%) for positively identifying patients with diffuse and focal symptomatic MM, and was negative in patients with indolent smoldering MM and monoclonal gammopathy of unknown significance. Three functional parameters—number of 11C-acetate–avid and 18F-FDG–avid focal bone lesions and 11C-acetate general marrow activity—strongly correlated with β-2-microglobulin as surrogate imaging markers of tumor burden. After induction chemotherapy, the metabolic change in 11C-acetate general marrow activity correlated with clinical response. Conclusion: Metabolic characterization of MM in diagnosis, risk stratification, and treatment monitoring can be done more accurately by assessing lipid metabolism with 11C-acetate than by assessing glucose metabolism with 18F-FDG.
In Vivo Evaluation of 18F-MNI698: An 18F-Labeled Radiotracer for Imaging of Serotonin 4 Receptors in Brain

Serotonin 4 receptors (5-hydroxytryptamine receptor 4 [5HT4R]) hold promise as a novel therapeutic approach to multiple brain disorders, including Alzheimer and Huntington disease. In vivo imaging of these receptors with selective 5HT4R radiotracers and PET would be valuable to investigate alterations in 5HT4R in different brain disorders and to assist drug discovery. In this study, 18F-MNI698 was evaluated as a potential PET radiotracer for imaging of 5HT4R in the brain. Methods: Eighteen PET studies were performed in 3 adult rhesus monkeys. The radiotracer was administered as a bolus intravenous injection or bolus plus constant infusion (time that would be required to inject the bolus at the infusion rate = 60 min), and arterial blood was collected for data quantification. Kinetic models were used to estimate distribution volumes and binding potentials, for which the cerebellum was used as a reference region. 18F-MNI698 test–retest variability and upper mass dose limits were determined. Preblocking studies using several doses of SB204070, a selective 5HT4R antagonist, were performed. Results: 18F-MNI698 avidly entered the monkey brain (peak percentage injected dose of ∼6.6%), and its brain distribution was consistent with known 5HT4R densities. At 120 min after bolus injection and after the start of radiotracer infusion, only less than 5% and approximately 10% parent compound was present in blood, respectively. Measured binding potentials were underestimated by 22%–36% when noninvasive methods were used for data quantification in comparison with invasive methods. A good agreement was found between test–retest measurements. The radiotracer upper mass dose limit (<5% occupancy) was determined to be 13.1 μg per 70 kg of body weight. SB204070 blocked the radiotracer binding in a dose-dependent manner. Conclusion: Data indicate that 18F-MNI698 is a promising PET radiotracer for imaging of 5HT4R in the brain, and human studies are warranted based on these study results.
Water-borne illness from contaminated drinking water sources in close proximity to a dumpsite in Payatas, The Philippines.

Improper solid waste disposal in the Philippines has threatened the environment and public health since it has caused the contamination of adjacent surface and ground waters that are the drinking water sources of many communities. Water pollution has contributed to high incidences of mortality and morbidity. This study assessed the significant factors causing waterborne illnesses among residents living in communities with and without the Payatas dumpsite. A cross-sectional study design was used. Householders in the “with” and “without dumpsite” communities of Payatas, Philippines were randomly selected and interviewed. Through the logit analysis and the use of survey data of confirmed cases from the records of health centers, the factors causing waterborne illnesses were disclosed. Frequent exposure to the dumpsites, and obtaining water from wells in Payatas, Philippines was found to have increased the occurrence of waterborne illnesses in individuals younger than 40 years old, with low educational attainment and in those having big household sizes. This study found that constant exposure of individuals to the dumpsite has led to considerable public health consequences. Considering that water pollution remains a key issue for public health action in the Philippines, the results should guide policymakers’ decisions on future environmental health policies.
In vitro bacteriologic study and empiric antibiotic regimens for diabetic foot ulcers

Hundred diabetic patients were admitted with clinically infected foot ulcers and were studied during the period of 1st January 2010 to 30th June 2011. Pus samples of bacterial culture were collected from 30 patients admitted with diabetic foot infection. Antimicrobial susceptibility testing of aerobic isolates was performed by the standard disc diffusion method as recommended by National Committee for the Clinical Laboratory Standards. Micro broth dilution test was arranged for susceptibility of anaerobic organisms to metronidazole and amoxicillin/clavulanate. A vencomycine screen agar (6 µg/ ml) was used to detect vencomycine intermediate isolates of Staphylococci. Clinical grading and bacteriological study of 100 patients revealed, 69 (69.0%) patients had Gram-negative organisms and Pseudomonas aeruginosa was the most common, while 21 (21.0%) patients had Gram-positive organisms and Staphylococci was the most common. Infection with anaerobic was found in one patient (1.0%). Both Gram-positive and –negative organisms were seen in 9 patients (9.0%). P. aeruginosa and Staphylococcus aureus exhibited a high frequency of resistance to the antibiotics tested. All the isolates were uniformly susceptible to fosfomycine, levofloxacin, amikacin and vencomycine. In this study P. aeruginosa, S. aureus, Escherichia coli, S. epidermidis and Proteus were the most common causes of diabetic foot infections. The rate of antibiotic resistance was 61.86% among the isolates. All the isolates were uniformly susceptible to fosfomycine, levofloxacine, amikacin and vencomycine. Key words: Diabetic foot Ulcer, Staphylococcus aureus, common pathogens, antibiotic resistance.
High-level modelling of critical infrastructures' interdependencies

Due to the increasing demand in services' quality and the growing concerns about external threats, the protection of critical infrastructures has recently become a major concern. In this article, we study the potential effect of interdependencies that may occur between two of these infrastructures: the telecommunication networks and the electrical network. In the absence of side protection mechanisms such as multihoming or batteries, these types of networks highly depend on each other. A failure of some component in one of these architectures may cause a fault in the other, for example, when an electrical outage occurs, routers may be switched off as soon as their battery has depleted. This can lead to cross-domain cascading effects in failures propagation that cause general service unavailabilty. To understand this phenomena, we propose a model that describes the behaviour of these interdependent systems. We show on realistic topologies that simple failures can lead to failures propagation and we derive the potential risk scenarios.
Value of Metabolic Tumor Volume on Repeated 18F-FDG PET/CT for Early Prediction of Survival in Locally Advanced Non–Small Cell Lung Cancer Treated with Concurrent Chemoradiotherapy

The aim of this study was to investigate the value of standardized uptake values (SUVs) and metabolic tumor volume (MTV) in 18F-FDG PET/CT to predict the survival of patients with locally advanced non–small cell lung cancer during the early stage of concurrent chemoradiotherapy. Methods: A total of 53 patients were included in the prospective study. All patients were evaluated by 18F-FDG PET before and after 40 Gy of radiotherapy with a concurrent cisplatin-based chemotherapy regimen. Semiquantitative assessment was used to determine the maximum and mean SUVs (SUVmax and SUVmean, respectively) and MTV of the primary tumor. The cutoffs for changes in SUVmax, SUVmean, and MTV (37.2%, 41.7%, and 29.7%, respectively) determined in a previous study were used with Kaplan–Meier curves to separate the groups. The prognostic significance of PET/CT parameters and other clinical variables was assessed using Cox regression analysis. Results: Overall survival (OS) at 1 and 2 y was 83.0% (46/53) and 52.8% (28/53), respectively. Survival curves for SUVmean and MTV were significantly different using the cutoffs. However, Cox regression analysis showed that the only prognostic factor for OS was a decrease in MTV. Conclusion: The use of repeated 18F-FDG PET to assess survival early during concurrent chemoradiotherapy is possible in patients with locally advanced non–small cell lung cancer. A decrease in MTV according to 18F-FDG uptake by the primary tumor correlates with higher long-term OS.
An experimental analysis of the impact of accuracy degradation in SVM classification

The aim of this paper is to analyse the phenomenon of accuracy degradation in the samples given as input to SVM classification algorithms. In particular, the effect of accuracy degradation on the performance of the learnt classifiers is investigated and compared, if possible, with theoretical results. The study shows how a family of SVM classification algorithms enhanced in order to deal with quality measures on the available data handles accuracy degradation better than the classical SVM approaches to classification.
EVALUATION OF SOME MATERNAL AND SOCIO-ECONOMIC FACTORS ASSOCIATED WITH LOW BIRTHWEIGHT AMONG WOMEN IN THE UPPER EAST REGION, GHANA

The birth of a child all over the world often comes with joy. Birthweight is a strong predictor of an individual baby’s survival and a person’s personality. It is one of the key indicators of the health and viability of the newborn infant. It is desired that birthweight should be in the range of 2.5 kg to 4.0 kg. Low birthweight has been defined by the World Health Organization (WHO) as weight at birth less than 2.5 kg. This study seeks to evaluate some of the factors that affect birthweight in the Upper East Region of Ghana. One hundred mothers with singleton live births were sampled and interviewed at birth maternity blocks of Bolgatanga Regional Hospital, Bolgatanga and War Memorial hospital, Navrongo. The factors considered include: gestational age, gestational weight gain, maternal educational level, parity, cigarette smoking habits, type of fuel used for cooking, maternal drinking habits, type of physical exercise undertaken, period of rest during pregnancy, and fundal height. The average birthweight of infants born in the Upper East Region was 2.98±0.53 kg. Correlating the variables, it was observed that most of the above-mentioned factors correlated linearly but insignificantly (p > 0.05) with birthweight. Results of multiple regressions conducted established that maternal educational level significantly determines birthweight (β = 0.34, p = 0.001). Within the limits of this research, maternal educational level contributed significantly in predicting birthweight in the region followed by duration of rest during pregnancy, pre-pregnancy weight, income level, and type of fuel used for cooking. The type of fuel used for cooking in the region contributed to low birthweight infants (β = -0.06, p = 0.567). The estimated weight gain during pregnancy and healthy lifestyle recorded in this study could be responsible for the attainment of appropriate birthweight specified by WHO. It is recommended that education of the girl-child should be taken seriously in the region.
Aromatase Imaging with [N-Methyl-11C]Vorozole PET in Healthy Men and Women

Aromatase, the last and obligatory enzyme catalyzing estrogen biosynthesis from androgenic precursors, can be labeled in vivo with 11C-vorozole. Aromatase inhibitors are widely used in breast cancer and other endocrine conditions. The present study aimed to provide baseline information defining aromatase distribution in healthy men and women, against which its perturbation in pathologic situations can be studied. Methods: 11C-vorozole (111–296 MBq/subject) was injected intravenously in 13 men and 20 women (age range, 23–67 y). PET data were acquired over a 90-min period. Each subject had 4 scans, 2 per day separated by 2–6 wk, including brain and torso or pelvis scans. Young women were scanned at 2 discrete phases of the menstrual cycle (midcycle and late luteal). Men and postmenopausal women were also scanned after pretreatment with a clinical dose of the aromatase inhibitor letrozole. Time–activity curves were obtained, and standardized uptake values (SUV) were calculated for major organs including brain, heart, lungs, liver, kidneys, spleen, muscle, bone, and male and female reproductive organs (penis, testes, uterus, ovaries). Organ and whole-body radiation exposures were calculated using OLINDA software. Results: Liver uptake was higher than uptake in any other organ but was not blocked by pretreatment with letrozole. Mean SUVs were higher in men than in women, and brain uptake was blocked by letrozole. Male brain SUVs were also higher than SUVs in any other organ (ranging from 0.48 ± 0.05 in lungs to 1.5 ± 0.13 in kidneys). Mean ovarian SUVs (3.08 ± 0.7) were comparable to brain levels and higher than in any other organ. Furthermore, ovarian SUVs in young women around the time of ovulation (midcycle) were significantly higher than those measured in the late luteal phase, whereas aging and cigarette smoking reduced 11C-vorozole uptake. Conclusion: PET with 11C-vorozole is useful for assessing physiologic changes in estrogen synthesis capacity in the human body. Baseline levels in breasts, lungs, and bones are low, supporting further investigation of this tracer as a new tool for detection of aromatase-overexpressing primary tumors or metastases in these organs and optimization of treatment in cancer and other disorders in which aromatase inhibitors are useful.