Miracle-dz/UniFAR-FTUs huggingface dataset:
A phase I study on the combination of neoadjuvant radiotherapy plus pazopanib in patients with locally advanced soft tissue sarcoma of the extremities

Abstract Accumulating evidence suggests significant synergism combining radiotherapy (RT) with angiogenesis targeted therapies. This multicenter prospective phase I clinical trial established the safety profile and recommended dose for further studies of pazopanib concurrent with preoperative RT in patients with extremity soft tissue sarcomas (ESTS) in curative setting. Methods. Patients with deep seated intermediate and high grade sarcomas, ≥ 5 cm, received once daily pazopanib (dose-escalation cohorts 400 mg, 600 mg and 800 mg) for 6 weeks and 50 Gy preoperative RT starting Day 8. Surgery was performed 5–7 weeks later. Toxicity was scored according to CTC criteria 4.0. Dose limiting toxicities (DLT) were divided into two separate sets; DLT-I being toxicities occurring during the 6-week chemoradiotherapy period within the radiation portals until day of surgery (designated as DLT-I) and those occurring perioperatively until Day 21 after surgery (DLT-II). Results. A total of 12 patients were enrolled, 11 were evaluable (3 females and 8 males, median age 58 years, range 24–78 years, median tumor size 9 cm, range 5–15 cm). Ten underwent surgery. No increased toxicity inside the radiation fields was seen, but two of 10 patients (one each in the 400 mg and 600 mg cohorts) showed delayed wound healing after surgery. None of the patients showed significant volume reductions after RT. Evaluation of the resection specimen showed pathological (near) complete responses (≥ 95% necrosis rate) in four of 10 cases. Unexpectedly, grade 3 + hepatotoxicity led to premature pazopanib interruption in three of 11 (27%) of cases. Conclusion. Apart from hepatotoxicity, neoadjuvant pazopanib 800 mg daily in combination with 50 Gy seems tolerable; the regimen appears to demonstrate promising activity in ESTS and is the recommended dose for further studies.
Levonorgestrel-releasing intrauterine system and the risk of breast cancer: A nationwide cohort study

Background. Prolonged steroid hormone therapy increases the risk of breast cancer, especially the risk of lobular cancer, but the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) use is controversial. In this study we aimed to test the hypothesis that risk for lobular breast cancer is elevated among LNG-IUS users. Material and methods. We identified from the national Medical Reimbursement Registry of Finland the women aged 30–49 who had used LNG-IUS for the treatment or prevention of menorrhagia in 1994–2007, and from the Finnish Cancer Registry breast cancers diagnosed before the age of 55 and by the end of 2012. Results. A total of 2015 women had breast cancer diagnosed in a cohort of 93 843 LNG-IUS users during follow-up consisting of 1 032 767 women-years. The LNG-IUS users had an increased risk for both ductal breast cancer [standardized incidence ratio (SIR) 1.20, 95% confidence interval (CI) 1.14–1.25] and for lobular breast cancer (SIR 1.33, 95% CI 1.20–1.46), as compared with the general female population. The highest risk was found in LNG-IUS users who purchased the device at least twice, whose SIR for lobular cancer was 1.73 (95% CI 1.37–2.15). Conclusions. The results imply that intrauterine administration of levonorgestrel is not only related to an excess risk of lobular breast cancer but also, in contrary to previous assumptions, to an excess risk of ductal breast cancer.
Ultrasound Measurement of Liver Span in Jordanian Adults: A Preliminary Experience

Background and Objective: One of the most frequent ultrasound requests by clinicians is evaluation of hepatic size. Clinical evaluation by percussion and palpation can be inaccurate, unreliable with significant inter-observer variation. Ultrasound remains a very important imaging modality when the liver is concerned because it is simple, practical and easy-to-use. Yet, ultrasound measurement of liver span didn’t receive much attention, particularly in this region. The aims of this study were to establish a normal figure of liver span for adults in Jordan, to investigate relationships between liver span and several anthropometric factors including age, gender, weight, height, body mass index and body surface area and to standardize ultrasound measurement of liver span. Methods: A prospective study was carried out at Jordan University Hospital between March 2007 and April 2008, on non-selected population sample of 242 male and 275 female adults with age range of 18-76 years. Statistical analyses including correlation, regression and 95% confidence intervals were performed on the data to test the statistical significance of the various relationships between liver span as represented by midclavicular line longitudinal diameter on one side, and several anthropometric factors including age, gender, weight, height, body mass index and body surface area. Results: our results showed that all anthropometric variables contributed highly and significantly to the variation in female liver span. The same factors however, with the exception of body mass index, significantly contributed to the variation in male liver span, however to a much lesser extent than females. The best predictor of liver span was height in case of males, body surface area in case of females, and both height and body surface area when both genders are considered. The 95% liver span confidence intervals were 12.3-12.8, 11.9-12.3 and 12.2-12.5 for males, females, and both genders combined, respectively. Conclusion: Height and body surface area were the best determinants of liver span in males and females, respectively.
Development and clinical application of assessment measures to describe and quantify intra-limb coordination during walking in normal children and children with cerebral palsy

This thesis investigates coordination of the lower limb joints within the limb during walking. The researcher was motivated by her clinical experience as a paediatric physiotherapist. She observed that the pattern of lower limb coordination differed between normal children and those with cerebral palsy. Many of the currently used interventions did not appear to influence this patterning. As a precursor to evaluating the effectiveness of treatments in modifying coordination, a tool to measure coordination was required. The researcher initially investigated qualitative and then quantitative methods of measuring within limb coordination. A technique was developed that used relative angular velocity of two joints to determine when joints were in-phase, antiphasic or in stasis. The phasic parameters of hip/knee, knee/ankle and hip/ankle joints coordination were quantified. There were some significant differences between normal children and children with cerebral palsy. Asymmetry of these phasic parameters was identified, with children with cerebral palsy being more asymmetrical than normal children. The clinical utility of this technique was tested by comparing 2 groups of children before and after 2 surgical procedures. This showed some significant differences in phasic parameters between pre and post-operative data for one procedure. Low samples sizes mean that further work is required to confirm these findings. Data from this work has been used to calculate sample sizes to give an a priori power of 0.8 and further research is proposed and potential applications discussed. It is hoped that this technique will raise awareness of abnormal intra-limb coordination and allow therapists to identify key interactions between joints that need to be facilitated during walking training.
THE CYP1A1 AND GSTM1 GENETIC POLYMORPHISMS AND SUSCEPTIBILITY TO ENDOMETRIOSIS IN WOMEN FROM SOUTH INDIA

Background: Endometriosis is one of the most commonly encountered benign problems in gynaecology. It is frequently associated with chronic pelvic pain, dysmenorrhoea, menorrhagia and dyspareunia, which lead to infertility. We determined the possible association between CYP1A1 MspI and GSTM1 null polymorphism in the pathogenesis of endometriosis. Materials and Methods: Ninety seven cases of endometriosis diagnosed by laparoscopy and one hundred two women without endometriosis were laparoscopically confirmed. Genomic DNA of heparinised blood were collected and null gene polymorphisms in GSTM1 and CYP1A1 genes coding for detoxification enzymes were identified by the PCR-based restriction fragment length polymorphism (RFLP) method. Results: The GSTM1 null mutation showed significant association (p<0.03) found between risk of endometriosis and GSTM1 null deletion with an odd ratio (OR) of 2.12, 95% CI: 1.04-4.31. The number of null genotype was more in stage III-IV cases compared to stage I-II. In contrast, we did not find significant association with the CYP1A1 MspI genotype. Conclusion: The study results suggest that women having high risk association with the GSTM1null polymorphism, but no association with the CYP1A1 MspI polymorphism for endometriosis in south Indian women.
‘Shaken Baby Syndrome’: child protection issues when children sustain a subdural haemorrhage

In recent years, there has been a dramatic increase in both professional and public awareness of the incidence of a condition commonly referred to as ‘shaken baby syndrome’. One of the most common markers of the syndrome is the detection of a subdural haemorrhage (SDH) in an infant. This paper is based on the results of a 2-year research study on the legal and social consequences which arise when children sustain a subdural haemorrhage. The study, which was funded by the Nuffield Foundation, is based on data collected from medical, police, social services and court records of sixty-eight children under the age of 2 years, who were diagnosed with a SDH between 1992 and 1998 in Wales and South West England.
Referral of sensation to an advanced humanoid robotic hand prosthesis

Hand prostheses that are currently available on the market are used by amputees to only a limited extent, partly because of lack of sensory feedback from the artificial hand. We report a pilot study that showed how amputees can experience a robot-like advanced hand prosthesis as part of their own body. We induced a perceptual illusion by which touch applied to the stump of the arm was experienced from the artificial hand. This illusion was elicited by applying synchronous tactile stimulation to the hidden amputation stump and the robotic hand prosthesis in full view. In five people who had had upper limb amputations this stimulation caused referral touch sensation from the stump to the artificial hand, and the prosthesis was experienced more like a real hand. We also showed that this illusion can work when the amputee controls the movements of the artificial hand by recordings of the arm muscle activity with electromyograms. These observations indicate that the previously described “rubber hand illusion” is also valid for an advanced hand prosthesis, even when it has a robotic-like appearance.
Factors Contributing to Sarcopenia among Community-dwelling Older Korean Adults

Purpose: This study was conducted to estimate the prevalence of sarcopenia and its associated factors in Koreans, who were 65 years of age or older. Methods: Data were from the Fifth Korea National Health and Nutrition Examination Survey. The appendicular skeletal muscle mass was measured by a dual x-ray absorptiometry in 770 men and 1,000 women. We defined sarcopenia as appendicular skeletal muscle mass/weight*100(%) less than 2 standard deviations below the mean for gender specific young, healthy reference populations. Health and nutritional factors were compared in participants with and without sarcopenia. Results: The prevalence of sarcopenia was 6.6% for men and 9.4% for women. Multiple logistic regression analysis showed that age, cancer, hypertension, and asthma were significantly associated with sarcopenia in men. However, in women, only one factor, current job, was significantly associated with sarcopenia. Conclusion: Sarcopenia was significantly associated with age, chronic disease, and current job in Korean elders. These results suggest that chronic disease and limited physical activity should be further investigated for their association with sarcopenia.
Expression Analysis of Angiogenic Growth Factors and Biological Axis CXCL12/CXCR4 Axis in Idiopathic Pulmonary Fibrosis

Idiopathic pulmonary fibrosis (IPF) is associated with aberrant repair, persistence of collagen deposition, and the development of vascular remodeling. However, the role of angiogenesis in the pathogenesis of IPF is still undetermined. The aim of this study was to evaluate the combined mRNA expression of vascular endothelial growth factor A (VEGFA), fibroblast growth factor 2 (FGF2), insulin-like growth factor 1 (IGF1) epidermal growth factor (EGF), and its receptor (EGFR) in lung tissue obtained from IPF patients. We have also investigated the expression of chemokine CXCL12/stromal cell-derived factor-1 (SDF-1) and its receptor, CXCR4, to identify alterations that maybe implicated in the pathogenesis of IPF. The subjects studied consisted of two distinct groups: patients with IPF (n = 25) and subjects (control) undergoing thoracic surgery for reasons other than interstitial lung disease (n = 10). Expression analysis of the aforementioned growth factors and biological axis CXCL12/CXR4 analysis were performed using real-time RT-PCR. IGF-1, EGF, and FGF2 mRNA levels are significantly decreased in the patients compared to the controls (p = 0.028, p = 0.023 and p = 0.009, respectively). SDF1-TR1 and SDF1-TR2 transcript levels were significantly lower in patients compared to controls (p = 0.017 and p = 0.001). Significant coexpression of VEGF mRNA with IGF mRNA was observed in the group of the patients (p = 0.017). An additional coexpression of VEGF mRNA with SDF1-TR1 mRNA was demonstrated(p = 0.030). Our results show a downregulation in angiogenetic mechanisms in IPF. However, our results should be further verified by measuring other angiogenetic pathways in more samples.
Análisis factorial de la Escala Valoración de Agencia de Autocuidado (ASA) en Colombia

Purpose. Validate, through factor analysis, the reliability and contents of the Appraisal of Self-care Agency Scale (ASA) in a hospital institution. Methods. This is a methodological study with secondary data for a sample of 201 adult patients listed in the database on chronically ill patients at Tunjuelito Hospital in Bogota, Colombia. Internal consistency (Cronbach alpha) and the factor structure were processed in SPSS11.5®. Results. The analysis of the principal components indicates a structure comprised of nine factors that explain 65.87% of the total variance. The instrument showed a Cronbach alpha of 0.68 and 0.74 corrected. Conclusion. The assessed Spanish version of the ASA was found to have psychometric properties that are valid and adequate for application in the different fields of nursing practice in Colombia
Fluoride effect on the secretory-stage enamel organic extracellular matrix of mice

The formation of an ordered enamel organic extracellular matrix (EOECM) seems to be a crucial step for the proper formation of the enamel mineral phase. The ordered supramolecular structure of the EOECM in the secretory stage can be analyzed using polarizing microscopy, as it is strongly birefringent. Excessive fluoride (F) ingestion during tooth development can cause enamel fluorosis, leading to increased porosity in mature enamel. We analyzed the effects of F on the birefringence of the EOECM in the A/J, CBA, and DBA/2 strains of mice given 0, 11.25, and 45 ppm of fluoride in drinking water. In the CBA and DBA/2 strains, the 11.25 and 45 ppmF groups presented a significant decrease in optical retardation (OR) when compared with the respective 0 (CBA 11.25 ppmF p = 0.0056 and 45 ppmF p < 0.0001; DBA/2 11.25 and 45 ppmF p < 0.05). ORs in A/J 0 ppmF were significantly higher than in 45 (p < 0.0001). The enamel of the A/J strain was more severely affected by fluoride than it was in the other strains of mice and exhibited the lowest levels of fluoride in plasma, whereas its normal secretory enamel presented a significantly higher protein absorbance than it did in CBA and DBA mice (p = 0.0099 and p = 0.0025, respectively). The results showed that experimental fluorosis can alter the supramolecular organization of EOECM in the secretory stage of amelogenesis and that the susceptibility to dental fluorosis seems to be influenced by the inherent characteristics of the developing enamel.
Bacteriology of the burn wound at the Bai Jerbai Wadia Hospital for children, Mumbai, India—A 13-year study, Part I-Bacteriological profile

Aim: To study which organisms were prevalent in our burn unit and their antibiotic sensitivity pattern in brief. Method: Microbiological data of 1534 patients admitted to the burns unit of the Bai Jerbai Wadia Hospital for Children, Mumbai over a period of 13 years (1994-2006) was reviewed retrospectively. A total of 9333 swabs were cultured and antibiotic sensitivities to the isolated organisms determined. The age group of patients admitted to our facility ranged from one month to 15 years. Result: Klebsiella was the predominant organism in our set-up (33.91%), closely followed by Pseudomonas (31.84%). The antibiotic sensitivities of the isolated organisms are discussed in detail in the text. Conclusion: Every treatment facility has microorganisms unique to it and these change with time. It is therefore of paramount importance to have an in-depth knowledge of the resident organisms and their antibiotic sensitivity pattern so that infection-related morbidity and mortality are improved.
Considering space weather forces interaction on human health: the equilibrium paradigm in clinical cosmobiology – is it equal?

Abstract Background: We are constantly affected by changes in space weather. The principal “players” are solar activity (SA), geomagnetic activity (GMA) and antagonistic to them, cosmic ray activity (CRA) and high energy proton flux. CRA is measured by neutron activity on the earth’s surface in imp/min. SA and GMA are linked and serve as a shield for the earth from CRA. For a long time SA and GMA were the main areas of studies. The aim of this study was to compare some effects of the mentioned forces and discuss the temporal distribution of both groups of space weather, in relation to their effects on humans. Methods: The time distribution of GMA storms (daily) was compared with quiet (low) GMA, with higher CRA (neutron activity). Space weather data were obtained from the USA, Russia and Finland. Results: A total of 4383 days were analyzed in the years 2000–2012. A total of 71 days (1.62%) of geomagnetic storms (GS) and 2753 days (63.8%) of quiet (I0) GMA were registered. A second study was provided including the years 1983–2007 (9131 days); here 3800 days (41.62%) were quiet GMA days and 400 storm days (4.38%). According to publications in the medical literature, many phenomena are connected with the extremes of space weather. Conclusions: Despite a great number of publications and the significant role of GS, it is a relatively rare event and most medical emergencies and deaths occur on days of low GMA, accompanied by higher CRA (neutron activity). High neutron activity deserves more attention when analyzing space effects on human health and their mechanism of action.
Validity of Heart Rate, Pedometry, and Accelerometry for Estimating the Energy Cost of Activity in Hong Kong Chinese Boys

This study compared the accuracy of heart rate monitoring, pedometry, and uniaxial and triaxial aecelerometry for estimating oxygen consumption during a range of activities in Hong Kong Chinese boys. Twenty-one boys, aged 8–10 years, walked and ran on a treadmill, played catch, played hopscotch, and sat and crayoned. Heart rate, uniaxial and triaxial accelerometry counts, pedometry counts, and scaled oxygen uptake (SVO2) were measured. All measures correlated significantly with VO2 scaled to body mass−0.75 (SVO2). The best predictor of SVO2 was triaxial accelerometry (R2 = 0.89). Correlations in this study were comparable with those in a previous study that used identical methods on 30 UK boys and girls. These results provide further confirmation that triaxial accelerometry provides the best assessment of energy expenditure and that pedometry offers potential for large population studies.
Two-stage reconstruction for flexor tendon injuries in zone II using a silicone rod and pedicled sublimis tendon graft

We report the results of staged flexor tendon reconstruction in 12 patients (12 fingers) with neglected or failed primary repair of flexor tendon injuries in zone II. Injuries involved both flexor digitorum profundus (FDP) and flexor digitorum sublimis (FDS), with poor prognosis (Boyes grades II–IV). The procedure included placing a silicone rod and creating a loop between the FDP and FDS in the first stage and reflecting the latter as a pedicled graft through the pseudosheath created around the silicone rod in the second stage. At a mean follow-up of 18 months (range 12–30 months), results were assessed by clinical examination and questionnaire. The mean total active motion of these fingers was 188°. The mean power grip was 80.0% and pinch grip was 76% of the contralateral hand. The rate of excellent and good results was 75% according to the Buck-Gramcko scale. These results were better than the subjective scores given by the patients. Complications included postoperative hematoma in two, infection in one, silicone synovitis in one (after stage I) and three flexion contractures after stage II. This study confirmed the usefulness of two-stage flexor tendon reconstruction using the combined technique as a salvage procedure to restore flexor tendon function with a few complications.
A study of Clinico-histopathological correlation of leprosy in a tertiary care hospital in western district of Rajasthan -

Background: The clinical manifestations of leprosy are so varied and divers and can mimic variety of unrelated diseases, so for the correct and adequate treatment, the diagnosis must be made early and it should be accurate, therefore clinic-pathological correlation is extremely important in patient care. Aims: To categorize Leprosy into various types based on microscopy and to correlate with clinical presentations. Materials and Methods: The data base of Department of Pathology, Dr. S. N. Medical College, Jodhpur was reviewed and total 423 clinically diagnosed leprosy patients of all age groups were included in the study. Results: A total 423 clinically diagnosed leprosy cases evaluated histopathologically. On clinical diagnosis most 74(17.5%) of the cases belonged to Borderline Borderline (BB) leprosy similarly, On histopathological study Borderline borderline (BB) subtype of leprosy was found most 106 (25.06%) common among all subtypes of leprosy and overall Clinico-histopathological agreement was seen in 266 (62.9%) cases and disagreement in 157(37.1%) cases. Conclusion: The discordance between clinical and histopathological diagnosis was noticed because the clinical diagnosis was made on the basis of Ridley-Jopling classification, even when a histopathological examination had not been made. So instead of using single criterion to diagnose leprosy, the researcher have to consider other contributory factors such as involvement of nerve, skin adnexae, epidermal atrophy, Grenz zone, erosion of the epidermis, granuloma (epithelioid/macrophage) and bacteriological index to arrive at a definitive diagnosis of leprosy. Key words: Leprosy, clinico-histopathological correlation