Miracle-dz/UniFAR-FTUs huggingface dataset:
Maternal and Birth Characteristics Are Determinants of Offspring Thyroid Function.

BACKGROUND Intrauterine adaptation to the outside environment is an important mechanism via which the fetus increases its chance to thrive after birth. Therefore, various maternal-, pregnancy-, and labor-related factors are potential determinants of thyroid function of the offspring. Animal studies suggest that very high maternal thyroid hormone levels during pregnancy can alter the development of the hypothalamic-pituitary-thyroid axis set point of the child. However, to what extent maternal and birth characteristics (including maternal thyroid function, smoking, and birth weight) are associated with thyroid function of the offspring is currently unknown. METHODS We selected 4273 mother-child pairs from a large population-based prospective cohort with data available on maternal gestational TSH and free T4 (FT4) levels and newborn TSH and FT4 (n = 3339; at birth) or childhood TSH and FT4 (n = 2523; median age, 6 y). We used multivariable (non)linear regression models to study the association of potential determinants (including maternal TSH, FT4, thyroid peroxidase antibodies, iodine excretion, age, body mass index, smoking status, parity, pre-eclampsia, fetal distress, gestational age at birth, birth weight, mode of delivery, and thyroid function-associated single nucleotide polymorphisms) with newborn and childhood TSH and FT4. RESULTS There was a strong association of maternal TSH and FT4 levels during pregnancy with newborn and childhood TSH and FT4 levels, respectively (for both, P < .0001). Maternal FT4 was also associated with newborn TSH levels (P = .0009). Birth weight, fetal distress, gestational age at birth and maternal parity were all associated with newborn TSH and/or FT4 (P < .0001), but these associations did not persist into childhood. Genetic risk scores for TSH and FT4 were strongly associated with newborn and childhood thyroid function (P ≤ .0005). The association between maternal and offspring thyroid function did not change after correction for genetic risk scores. CONCLUSIONS In this study, childhood thyroid function was predominantly determined by maternal TSH or FT4 levels and thyroid-specific single nucleotide polymorphisms. Effects of stress-related changes in thyroid function at birth were transient. Other potential factors were not associated with offspring thyroid function.
Clinical Relationship Between IgG4-Positive Hashimoto's Thyroiditis and Papillary Thyroid Carcinoma.

CONTEXT Hashimoto's thyroiditis (HT) can be divided into IgG4-positive and IgG4-negative HT. The potential association between IgG4-positive HT and papillary thyroid carcinoma (PTC) remains poorly understood. OBJECTIVE The aim was to investigate the relationship between IgG4-positive HT and PTC and to compare the prognostic parameters of PTC patients with and without IgG4-positive HT. DESIGN This was a retrospective study. PATIENTS AND SETTING A total of 66 HT patients (18 HT-alone, 48 HT with PTC) with serum samples stored before the operation were collected. Another 18 PTC-alone patients were collected as controls. MAIN OUTCOMES Expression of IgG4, IgG, and TGF-β1 in thyroid tissues and serum levels of IgG4, TgAb IgG, TgAb IgG4, TPOAb IgG, and TPOAb IgG4 were measured. RESULTS Seventeen HT patients with PTC (35.4%) were IgG4-positive HT, whereas only one patient (5.6%) was found to be IgG4-positive in the HT-alone group. In contrast, there were only a few IgG4-positive plasma cells in the PTC-alone group. The association of IgG4-positive HT and PTC was statistically significant (P < .05). Moreover, serum levels of TgAb IgG4 and the ratios of TgAb IgG4 to TgAb IgG were significantly higher in the HT with PTC and the PTC-alone groups than in the HT-alone group (P < .05). Furthermore, in the HT with PTC group, the average tumor diameter of 17 IgG4-positive HT with PTC patients was 1.7 ± 0.8 cm, whereas of 31 IgG4-negative HT patients with PTC, the diameter was 1.2 ± 0.6 cm (P = .01). A considerably higher percentage of lymph node metastasis (41.2% vs 12.9%; P = .026) was found in PTC patients with IgG4-positive HT as compared with those with IgG4-negative HT. CONCLUSION PTC may be facilitated by preexisting autoimmune inflammation of IgG4-positive HT. IgG4-positive HT with PTC cases may have worse clinical outcomes. The high levels of TgAb IgG4 might present a risk factor for PTC.
Cost of Peritoneal Dialysis and Haemodialysis across the World

This report summarizes the scientific paper comparing the costs of hemodialysis (HD) and peritoneal dialysis (PD) in several countries, which was published on NDT in June 2013. After thorough literature review, the Authors found that PD is less expensive than HD in most developed countries. In developing countries the situation is rather variable and the costs of DP and HD are generally similar where economies of scale have been realized.
Increased F3-Isoprostanes in the Canadian Inuit Population Could Be Cardioprotective by Limiting F2-Isoprostane Production.

CONTEXT F3-isoprostanes (F3-IsoPs), derived from peroxidation of eicosapentaenoic acid (C20:5n-3), could be cardioprotective by limiting production of F2-isoprostanes (F2-IsoPs), a cardiovascular disease risk factor. OBJECTIVE The objective of the study was to determine whether the n-3-polyunsaturated (PUFA)-rich Inuit diet is associated with a lower plasma ratio of F2-IsoPs to F3-IsoPs. DESIGN This was a cross-sectional observational study. SETTING The study was conducted in 36 Canadian Arctic Inuit communities. PARTICIPANTS Participants included a random subset (n = 233) of Inuit adults taken from a population-based survey. MAIN OUTCOME MEASURES Plasma F2-IsoPs and F3-IsoPs, cardiometabolic risk factors (blood lipids, C-reactive protein, blood pressure, fasting glucose) and markers of dietary exposure (erythrocyte n-3 and n-6 PUFA, blood levels of Se, mercury, polychlorinated biphenyls) were measured. RESULTS Inuit aged 40 years old and older vs younger Inuit showed higher concentrations of plasma F3-IsoPs and erythrocyte n-3 PUFA and lower plasma F2-IsoPs concentrations despite having higher blood lipids, fasting glucose, systolic blood pressure, and percentage body fat. Plasma F3-IsoPs were not associated with any cardiometabolic measures. When subjects were categorized into tertiles according to total n-3 PUFA erythrocyte concentrations, F3-IsoPs increased with increasing tertiles, whereas the F2-IsoP to F3-IsoP ratio was lowest at the highest n-3 tertile. The F2-IsoP to F3-IsoP ratio was significantly predicted by C20:5n-3 (β= -.365, P = .002); C20:4n-6:C20:5n-3 (β = .056, P = .006), blood mercury (β = -.812, P =.015), blood Se (β = -1.95, P = .015), and smoking (β = .745, P = .025). CONCLUSIONS Plasma F3-IsoPs were not associated with cardiometabolic risk factors previously seen with F2-IsoPs. Higher n-3 fatty acid status was associated with lower plasma F2-IsoPs and higher plasma F3-IsoPs, which provides partial explanation to the cardioprotective effects of the n-3 PUFA-rich Inuit diet.
Tumor-Infiltrating T Cells and the PD-1 Checkpoint Pathway in Advanced Differentiated and Anaplastic Thyroid Cancer.

CONTEXT Five to 10% of patients with differentiated thyroid cancers (DTC) develop invasive and/or distant metastatic disease that is marginally improved with standard therapies. Prognosis is poor for patients with anaplastic thyroid cancer, with a median survival of 3-5 months. We suggest that a paradigm shift is necessary in the treatment of advanced cases. OBJECTIVE We hypothesized that a T-cell response is generated in advanced thyroid cancer and may be a viable therapeutic target. DESIGN Primary DTCs were analyzed by quantitative RT-PCR (n = 92) for expression of CD3, CD8, forkhead box (Fox)-P3, programmed death (PD)-1, PD-1 ligand-1, and PD-1 ligand-2 and biopsied for cellular analysis by flow cytometry (n = 11). Advanced pT4 cases (n = 22) and metastases (n = 5) were analyzed by immunohistochemistry. SETTING The study was conducted at the University of Colorado Hospital. PATIENTS Thyroid cancer patients undergoing thyroidectomy or completion surgery for advanced disease between 2002 and 2013 participated in the study. INTERVENTION There were no interventions. MAIN OUTCOME MEASURE Immune markers were analyzed for association with disease severity. RESULTS Immune markers were commonly expressed at the RNA level. PD-L1 was higher (P = .0443) in patients with nodal metastases. FoxP3(+) (P < .0001), PD-1(+)CD8(+) (P = .0058), and PD-1(+)CD4(+) (P = .0104) T cells were enriched in DTC biopsies. CD8(+) and FoxP3(+) T cells were detected by immunohistochemistry in all pT4 tumors and a subset of metastases. PD-1(+) lymphocytes were found in 50% of DTCs. PD-L1 was expressed by tumor and associated leukocytes in 13 of 22 cases, and expression was more diffuse in anaplastic thyroid cancer (P = .0373). BRAF(V600E) mutation was associated with higher frequencies of tumor-associated lymphocytes (P = .0095) but not PD-L1 expression. CONCLUSIONS PD-1 checkpoint blockades may have therapeutic efficacy in patients with aggressive forms of thyroid cancer.
Investigations of spread of canine Brucellosis caused by Brucella canis in territory of Municipality of Požarevac

The paper examines the presence and distribution of infections caused by Brucella canis in different categories of dogs in the territory of the Municipality of Požarevac. A total of 151 dogs were examined, and 74 blood serums originated from dogs of known owners and 77 from stray dogs. The investigations were carried out also on 40 samples of full blood of stray dogs, as well as fetal organs and reproductive organs of a serologically positive female following hysterectomy. Investigations included a clinical examination of the dogs, rapid serum agglutination, slow serum agglutination, and isolation of the cause. In all the examined dogs, the rapid agglutination test gave a positive result in 16.55% of the examined samples, the slow agglutination test 11.25%, which is an extremely high percentage in comparison with other regions of our country. Therapy using antibiotics, zoohygienic measures, castration or hysterectomy (as attempts to avoid residue and break the chain of the transfer of the infection) are conditions for out rooting the disease. Control of stray dogs is necessary, as they present the basic source of the infection. The results obtained in the course of these investigations indicate the absolute justification of including this contagious disease in the group of diseases whose reporting is compulsory.
Clinical, Genetic, and Biochemical Characteristics of Early-Onset Diabetes in the Finnish Population.

CONTEXT Major advances have been made in the classification and genetics of monogenic diabetes in infancy. OBJECTIVE The objective of the study was to characterize different forms of diabetes diagnosed during the first year of life. DESIGN Patients diagnosed with diabetes before the age of 1 year in 10 Finnish hospitals from 1980 to 2014 were included. SETTING The study was conducted at Kuopio University Hospital and University of Eastern Finland. PATIENTS Patients were identified through diagnosis-based searches from hospital registries including 93 children, of whom 64 participated. INTERVENTIONS DNA sample for sequencing, serum sample, and medical records interventions were included. MAIN OUTCOME MEASURES Incidence of diabetes during the first year of life, sequencing results, human leukocyte antigen (HLA) genotypes, and islet autoantibodies were measured. RESULTS The incidence of diabetes diagnosed during the first 12 months was 4.4/100 000/year. Three novel and 11 previously described mutations were found in 22 patients from 15 families in the KCNJ11, ABCC8, INS, GCK, FOXP, STAT3, and RFX6 genes. Positive islet autoantibodies were observed in 40.0% of the patients diagnosed during the first 0-6 months of life vs 70.8% of the patients diagnosed between ages of 7 to 12 months. A total of 85.7% of the patients carrying protective HLA genotypes were mutation-positive compared to 7.7% of the patients having high-risk genotypes (P = .001). CONCLUSIONS Mutations in the K-ATP channel and INS genes were the most common cause of early diagnosed monogenic diabetes. After 6 months of age, patients with diabetes had high HLA risk genotypes and islet autoantibodies, reflecting the autoimmune character of diabetes in that age group.
Advanced Glycation Endproducts and Bone Material Strength in Type 2 Diabetes.

CONTEXT Skeletal deterioration, leading to an increased risk of fracture, is a known complication of type 2 diabetes mellitus (T2D). Yet plausible mechanisms to account for skeletal fragility in T2D have not been clearly established. OBJECTIVE The objective of the study was to determine whether bone material properties, as measured by reference point indentation, and advanced glycation endproducts (AGEs), as determined by skin autofluorescence (SAF), are related in patients with T2D. DESIGN This was a cross-sectional study. SETTING The study was conducted at a tertiary medical center. PATIENTS Sixteen postmenopausal women with T2D and 19 matched controls participated in the study. MAIN OUTCOME MEASURES Bone material strength index (BMSi) by in vivo reference point indentation, AGE accumulation by SAF, and circulating bone turnover markers were measured. RESULTS BMSi was reduced by 9.2% in T2D (P = .02) and was inversely associated with the duration of T2D (r = -0.68, P = .004). Increased SAF was associated with reduced BMSi (r = -0.65, P = .006) and lower bone formation marker procollagen type 1 amino-terminal propeptide (r = -0.63, P = .01) in T2D, whereas no associations were seen in controls. SAF accounted for 26% of the age-adjusted variance in BMSi in T2D (P = .03). CONCLUSIONS Bone material properties are impaired in postmenopausal women with T2D as determined by reference point indentation. The results suggest a role for the accumulation of AGEs to account for inferior BMSi in T2D.
Low Testosterone: A Risk Marker Rather Than a Risk Factor for Type 2 Diabetes.

CONTEXT Low serum T levels have been associated with type 2 diabetes (T2D) and cardiovascular disease. However, it is unresolved whether low T is a risk factor or rather a risk marker for these conditions. OBJECTIVE The objective of the study was to investigate serum levels of total T, SHBG, free T, estradiol, LH, and FSH and the subsequent risk of T2D and/or cardiovascular disease. DESIGN, SETTING, AND PARTICIPANTS A prospective cohort study consisting of 5350 men from the general population aged 30-70 years at baseline, examined between 1982 and 2001 and followed with complete registry follow-up until December 2011, ie, up to 29 years of follow-up. MAIN OUTCOME MEASURES T2D outcomes defined as the first diagnosis of T2D and cardiovascular outcomes defined as first diagnosis of either ischemic heart disease or stroke (ischemic and hemorrhagic stroke). RESULTS In Cox proportional hazards models, a significantly negative association between T quartile and the risk of T2D was seen. Similarly, men with SHBG in the highest quartile had a decreased risk of developing T2D (nonsmokers: hazard ratio 0.30, 95% confidence interval 0.14-0.63; smokers: hazard ratio 0.40, 95% confidence interval 0.20-0.78). Similar trends were seen for free T, however, insignificant in the fully adjusted analysis. No associations were seen for estradiol, LH, and FSH. A less consistent pattern was seen for the hormones in relation to CVD outcomes; nonsmoking men showed a pattern of higher levels of total T, SHBG, and LH being negatively associated with ischemic heart disease and less pronounced for stroke, whereas in smokers higher levels of total T, free T, and LH were positively associated with the two CVD outcomes. CONCLUSIONS The observed negative associations of T and SHBG with T2D, but no association to LH and free T, indicates that low T in men who develop T2D is a marker of the disease rather than primary hypogonadism being a causal risk factor.
Complex Influence of Gonadotropins and Sex Steroid Hormones on QT Interval Duration.

CONTEXT QT interval duration is longer in women than in men. Sex steroid hormones have inconsistently been suggested to explain this difference. The implication of gonadotropins has never been studied. OBJECTIVE We report here the combined influence of sex steroid hormones and gonadotropins on QT interval duration in healthy subjects and patients with congenital adrenal hyperplasia (CAH) as a model of T and progesterone overexpression. DESIGN AND PATIENTS Eighty-four CAH patients (58 women) and 84 healthy subjects matched and paired for sex and age were prospectively included. Circulating concentrations of 17-OH-progesterone, progesterone, T, estradiol, FSH, and LH were measured concomitantly to the recording of a digitized electrocardiogram. RESULTS QTcFridericia (QTcF) was shorter in women with CAH than in control women (404 ± 2 vs 413 ± 2.1 milliseconds; P ≤ .001). 17-OH-progesterone, progesterone, the progesterone/estradiol ratio, and total T were higher in women with CAH than in female controls (P < .05), whereas FSH was lower (P ≤ .05). According to multivariable analysis in all women, the progesterone/estradiol ratio (β = -0.33) and FSH levels (β = 0.34) were related to QTcF (r = 0.5; P < .0001), with no influence of CAH or healthy status. QTcF was not different between CAH (404.7 ± 3.7 milliseconds) or healthy men (396 ± 2.8 milliseconds). For men, QTcF (r = 0.48; P < .01) was negatively related to free T (β = -0.29) and positively to FSH levels (β = 0.34). CONCLUSION Cardiac repolarization is influenced by complex interactions between sex steroid hormones and gonadotropins, depending on gender. Our results indicate that the progesterone/estradiol ratio in women, T in men, and FSH in both genders are major determinants of ventricular repolarization with opposite effects on QTc interval.
An acute bout of endurance exercise but not sprint interval exercise enhances insulin sensitivity.

An acute bout of endurance exercise (EE) enhances insulin sensitivity, but the effects of sprint interval exercise (SIE) have not yet been described. We sought to compare insulin sensitivity at baseline and after an acute bout of EE and SIE in healthy men (n = 8) and women (n = 5) (age, 20.7 +/- 0.3 years; peak oxygen consumption (VO2 peak), 42.6 +/- 1.7 mL.kg(-1). min(-1); <1.5 days.week(-1) structured exercise; body fat, 21.1 +/- 1.9%). Subjects underwent 3 oral glucose tolerance tests (OGTT(s)) the day after each of the following 3 conditions: no exercise, baseline (OGTT(B)); SIE at approximately 125% VO(2 peak) (OGTT(SIE)); and EE at approximately 75% VO(2 peak )(OGTT(EE)). SIE and EE sessions were randomized for each subject. Subjects consumed identical meals the day preceding each OGTT. Two insulin sensitivity indices - composite whole-body insulin sensitivity index (ISI-COMP) and ISI-hepatic insulin sensitivity (HOMA) - were calculated, using previously validated formulas (ISI-COMP = 10 000/ radical(glucose(fasting)) x insulin(fasting) x glucose(mean OGTT) x insulin(mean OGTT)); ISI-HOMA = 22.5/(insulin(fasting) x glucose(fasting)), and the plasma concentrations of cytokines interleukin-6 and tumor necrosis factor-alpha were measured. There were no differences by sex for any condition (men vs. women, p > 0.05). Pearson's correlation coefficients between ISI-COMP and ISI-HOMA for each condition were highly correlated (p < 0.01), and followed similar patterns of response. ISI-COMP(EE) was 71.4% higher than ISI-COMP(B) (8.4 +/- 1.4 vs. 4.9 +/- 1.0; p < 0.01) and 40.0% higher than ISI-COMPSIE (8.4 +/- 1.4 vs. 6.0 +/- 1.5; p < 0.05), but there was no difference between ISI-COMP(B) and ISI-COMP(SIE) (p = 0.182). VO(2 peak) was highly correlated with both ISI-COMP and ISI-HOMA during baseline and SIE test conditions (p < 0.02). These findings demonstrate that an acute bout of EE, but not SIE, increases insulin sensitivity relative to a no-exercise control condition in healthy males and females. While these findings underscore the use of regular EE as an effective intervention strategy against insulin resistance, additional research examining repeated sessions of SIE on insulin sensitivity is warranted.
Adherence to medical treatment in primary open-angle glaucoma in Egypt

Purpose The aim of the study was to find the state of adherence to medical treatment and the factors affecting it among Egyptian primary open-angle glaucoma patients. Patients and methods A total of 110 adult patients, previously diagnosed with primary open-angle glaucoma, were administered a questionnaire that included most of the potential causes of nonadherence (defined as missing one or more doses of a previously prescribed topical intraocular pressure (IOP)-reducing eye drop during the last 4 weeks) to glaucoma medication reported in the literature (based on age, sex, education level, illness duration, association of other chronic diseases, medication side effects, instillation difficulties, fear of blindness, concept of missing one dose only, hope of prognosis, number of used drugs, and financial cost) during their usual follow-up visit to the outpatient clinic of the Nile Health Insurance Hospital from November 2009 to May 2010. Results Forty-two (38.8%) patients were found to be nonadherent and 68 (61.8%) patients were adherent (no missed doses in the last 4 weeks). Hope of controlling the disease had a statistically significant positive effect on adherence to treatment, whereas the presence of other chronic illnesses had a positive statistically significant effect on nonadherence. The effect of other factors, such as age, sex, education level, illness duration, medication side effects, instillation difficulties, fear of blindness, concept about missing one dose only, number of used drugs, and financial cost, although affecting the adherence level, were statistically insignificant. Conclusion Despite the recent development of drugs with relatively simpler treatments and fewer side effects, nonadherence to topical hypotensive treatment continues to be a considerable obstacle in the treatment of glaucoma patients. The mood of the patient and awareness about his illness are very important factors that determine the adherence level. Fear of blindness and the hope of a good prognosis are powerful motivating factors.
Evaluating the Swedish version of the Falls Efficacy Scale-International (FES-I)

A number of instruments measuring psychological outcomes of falling exist, e.g. the Falls Efficacy Scale (FES). An extended version of the FES, the Falls Efficacy Scale-International (FES-I), has been developed and translated into several European languages. The aims of this study were to evaluate internal reliability, examine the internal structure of the FES-I(S) (the Swedish version of the FES-I), and to examine the correlation between fear of falling and health-related quality of life measured with Short Form 12 (SF-12). Eighty-six participants, aged 50–85 years (88% women), recruited from the Orthopaedic Department, Lund University Hospital, and treated for a fall-related fracture, answered the FES-I(S), SF-12 and a questionnaire of background factors. The FES-I(S) showed a high internal reliability (Cronbach's α=0.95) and an inter-item correlation averaging 0.55. Factor analyses discriminated two factors dominated by items of less and more demanding physical activities, respectively. All items loaded strongly on a unitary underlying dimension There were significant correlations (p=0.01) between the FES-I(S) and SF-12 physical component score and the FES-I(S) and SF-12 mental component score with Spearman's rank correlation coefficient of −0.591 and −0.402, respectively. The FES-I(S) will be useful to assess fear of falling in Sweden in rehabilitation research and in clinical trials. Further studies are suggested to verify FES-I(S) validity.