Miracle-dz/UniFAR-FTUs huggingface dataset:
Defining Lower Limb Lymphedema After Inguinal or Ilio-Inguinal Dissection in Patients With Melanoma Using Classification and Regression Tree Analysis

Objective:This study aims to objectively define the criteria for assessing the presence of lymphedema and to report the prevalence of lymphedema after inguinal and ilio-inguinal (inguinal and pelvic) lymph node dissection for metastatic melanoma. Summary Background Data:Lymphedema of the lower limb is a common problem after inguinal and ilio-inguinal dissection for melanoma. The problem is variably perceived by both patients and clinicians. Adding to the confusion is a lack of a clear definition or criteria that allow a diagnosis of lymphedema to be made using the various subjective and objective diagnostic techniques available. Methods:Lymphedema was assessed in 66 patients who had undergone inguinal or ilio-inguinal dissection. Nine patients received postoperative radiotherapy. Assessment was performed by limb circumference measurements at standardized intervals, volume displacement measurements, and volumetric assessment calculated using an infrared optoelectronic perometer technique. Comparisons were made with the contralateral untreated limb. Patient assessment of the severity of lymphedema was compared with objective measures of volume discrepancy. Classification and regression tree analysis was used to determine a threshold fractional leg volume or circumference increase above which patients could self-detect volume changes that they reliably considered to indicate lymphedema. Results:Based on classification and regression tree analysis, both the whole limb perometer volume percentage change ≥15% and the sum of circumferences (of 6 defined sites along the limb) percentage change ≥7% performed well overall in predicting moderate or severe perceived swelling (defined as “lymphedema”). Both definitions predicted lymphedema in approximately the same fraction of patients with misclassification rates of 16% and 15%, sensitivity 56% and 50%, specificity 95% and 100%, respectively. Using ≥15% of whole perometer volume percentage change, 12% of patients with inguinal dissection had lymphedema compared with 23% of patients with ilio-inguinal dissection. Combining both groups, 18% of patients had lymphedema, positive and negative predictive values 82% and 84%. Using the definition ≥7% of the sum of circumferences percent change, 7% of patients with inguinal dissection had lymphedema compared with 19% of patients with ilio-inguinal dissection (overall 14% had lymphedema, positive and negative predictive values 100% and 82%, respectively). Of the variables assessed, only radiotherapy was significantly associated with predicted lymphedema (OR 12.6; 95% CI 1.7 to >100; P = 0.001 using whole perometer change ≥15%; and OR 13.0; 95%CI 1.4 to >100; P = 0.021 using sum circumference change ≥7%). Conclusions:A whole limb perometer volume percentage change of ≥15% and increase in the sum of circumferences of the defined points along the limb ≥7% provide robust definitions of lower limb lymphedema.
Endoscopic Removal of Large Colorectal Polyps: Prevention of Unnecessary Surgery?

PURPOSE Because of the potential risk of malignancy and technical difficulties in achieving complete removal, large colorectal polyps represent a special problem for the endoscopist. The aim of this study was to evaluate the capabilities and risks of endoscopy in complete removal of large colorectal polyps. METHODS Endoscopic polypectomy of 186 colorectal polyps larger than 3 cm in diameter (range, 3–13 cm) was performed; 141 were sessile and 45 pedunculated. Most of the polyps were located in the rectum (n = 88), sigmoid (n = 63), and cecum (n = 9). The remaining adenomas were situated in other parts of the colon. Sessile polyps were removed using the piecemeal technique. RESULTS Histology results showed an adenoma in 167 cases, and invasive carcinoma was present in the adenoma in 19 patients. Of the adenomas, 29 were tubulous, 118 tubulovillous, and 20 villous; adenoma with severe dysplasia was found in 49 cases. Complete endoscopic removal was achieved in all sessile and pedunculated polyps. None of the patients with invasive carcinoma who underwent surgical resection (n = 10) had any evidence of tumor in the resected specimen. Bleeding occurred in 4 patients after polypectomy (2 percent). Perforation occurred in 1 patient (0.5 percent), who had an invasive carcinoma of the cecum. There was no procedure-related mortality. During a mean follow-up period of 40 (range, 3–87) months, 6 patients presented with recurrence of a benign adenoma (3 percent), which was treated endoscopically, and 1 patient presented with a recurrent invasive carcinoma, which was treated surgically. CONCLUSIONS Endoscopic polypectomy is a safe and effective method of treating large colorectal polyps.
Interferon induction in mouse spleen cells by mitogenic and nonmitogenic lectins.

Twenty-two species of lectin were tested for their ability to induce interferon (IFN) in mouse spleen cells. Twenty-two species of lectins representing four groups, based on competition patterns with monosaccharides, were examined for their ability to induce IFN in cultured mouse spleen cells. The lectins, all belonging to the third group (concanavalin A, succinylated concanavalin A, Lens culinaris lectins type A and B, and poke weed mitogen) induced IFN mainly composed of IFN gamma. They were either T cell or T/B cell mitogens. Five nonmitogenic lectins, Lotus tetragonolobus seed lectin, crude and type II lectins of Ulex europeus, Bandeiraea simplicifolia type II and Salanum tuberosame lectins, and wheat germ agglutinin belonging to either the first or the third group, induced IFN beta. The production of IFN during stimulation IFN beta- and IFN gamma-inducing lectins followed different kinetic curves. WGA induced IFN in circulation when injected i.p. in mice, and a peak titer was found 2 hr after inoculation.
Modélisation numérique pour l'acoustique environnementale : simulation de champs météorologiques et intégration dans un modèle de propagation

Il existe aujourd'hui un enjeu societal majeur a s'interesser a la propagation du son en milieu exterieur etnotamment, dans notre contexte, a diminuer l'incertitude sur l'estimation des niveaux sonores et ameliorer ainsi laprecision des diverses analyses, du bureau d'etude a l'institut de recherche. Dans le cadre de l'acoustiqueenvironnementale, l'influence des conditions meteorologiques sur la propagation acoustique en milieu exterieurpeut etre importante. Il est donc necessaire d'apprehender et de quantifier les phenomenes meteorologiques demicro-echelles que l'on observe dans la couche limite atmospherique.Dans ce but, le modele meteorologique de recherche de Meteo-France (Meso-NH) a ete utilise. Apres avoircompare les resultats de ce modele a tres fine resolution (de l'ordre du metre) a l'aide des bases de donnees de deuxcampagnes experimentales (Lannemezan 2005 et la Station de Long Terme), il s'est avere necessaire de developpercet outil en integrant la prise en compte de la force de trainee des arbres. Des lors, les resultats issus de Meso-NH surles champs de vent, de temperature et d'energie cinetique turbulente aparraissent satisfaisants. Ces informationssont par la suite utilisees en donnees d'entree du modele de propagation acoustique.Le modele acoustique temporel utilise est base sur la methode Transmission Line Matrix (TLM). Sondeveloppement a ete effectue dans le but d'etre applique a la propagation acoustique en milieu exterieur : prise encompte du relief, de differents types de sol, des conditions atmospheriques, etc. La validation numerique de lamethode TLM, par comparaison avec d'autres modeles (analytique et numerique de type Equation Parabolique), apermis de montrer la pertinence de son utilisation dans le cadre de l'acoustique environnementale.Enfin, a l'aide de ces modeles, des niveaux sonores simules sous differentes conditions de propagation(favorables, defavorables, homogenes) ont ete compares aux mesures in-situ realisees lors de la campagneexperimentale de Lannemezan 2005. Les resultats se sont averes tres satisfaisants au regard de la variabilite desphenomenes observes. Cependant, l'utilisation des champs issus d'un modele micro-meteorologique de type Meso-NH reste delicate du fait de la forte sensibilite du niveau sonore aux profils verticaux de celerite du son. L'etude defaisabilite sur une experience plus complexe (la Station de Long Terme) est encourageante et, a condition de disposerd'importants moyens de calculs, elle permet de considerer la TLM comme une nouvelle methode de reference etainsi, d'envisager d'elargir son domaine d'utilisation a d'autres applications.
Poster: RailCop: Detecting Missing Rail on Railway Using Wireless Sensor Networks

In recent times, derailments due to uprooting rails on a railway track has become a banal and noteworthy occurrence in Bangladesh due to different reasons such as political unrest, mass protest, etc. However, the railway tracks in Bangladesh are yet to deploy an automated system that can prevent the losses due to derailments through early detection of missing rails on a railway track. As a remedy to this situation, in this project, we propose to develop a WSN based automated system, which can sense the discontinuity of rail blocks and thus prevent from derailment of trains.
NMR structure of the 5′ splice site in the group IIB intron Sc.ai5γ—conformational requirements for exon–intron recognition

Identification of the 5′ splice site by group II introns involves a base-pairing interaction between the exon-binding site EBS1 and the intron-binding site IBS1. This study presents an NMR structure of this interaction. This structure reveals that the EBS1•IBS1 interaction presents the scissile phosphate at the 5′ splice site in a position that is structurally unique.
CD13 (aminopeptidase N) can associate with tumor‐associated antigen L6 and enhance the motility of human lung cancer cells

Cancer metastasis is a multiple‐step process that involves the regulated interaction of diverse cellular proteins. We recently reported that the expression of tumor‐associated antigen L6 (TAL6) promoted the invasiveness of lung cancer cells and was inversely correlated with disease‐free survival of squamous lung carcinoma patients. We now report that CD13 (aminopeptidase N) can associate with TAL6 and can enhance cancer cell migration. CD13 was shown by coimmunoprecipitation to associate in vitro with TAL6 on several cancer cell lines and to associate in vivo by antibody‐mediated copatching immunofluorescence. CD13 was selectively expressed on highly invasive CL1‐5 lung cancer cells as compared to poorly invasive CL1‐0 lung cancer cells. The role of CD13 aminopeptidase activity in regulating cell motility was investigated with chemical inhibitors, specific antibodies and a catalytically inactive CD13 protein. Inhibition of CD13 aminopeptidase activity by nontoxic concentrations of leuhistin modestly decreased the migration of CL1‐5 cells. In contrast, binding of CD13 by specific antibodies significantly reduced both the migration and the invasion of CL1‐5 cells. Poorly invasive CL1‐0 cells that stably expressed CD13 displayed significantly (p ≤ 0.0005) enhanced cell migration (300% of control). Expression of an enzymatically inactive CD13 mutant on CL1‐0 cells also significantly (p ≤ 0.0005) enhanced cell migration (200% of control). Our results show that TAL6 and CD13 can form a complex on lung cancer cells, that these molecules can modulate cell migration and invasion and that the influence of CD13 on cell motility did not strictly depend on its aminopeptidase activity. © 2005 Wiley‐Liss, Inc.
Influence of age on leptin induced skeletal muscle signalling

Age associated fat mass accumulation could be because of dysregulation of leptin signalling in skeletal muscle. Thus, we investigated total protein expression and phosphorylation levels of the long isoform of the leptin receptor (OB‐Rb), and leptin signalling through janus kinase 2 (JAK2)/signal transducer and activator of transcription 3 (STAT3), insulin receptor substrate 1 (IRS‐1), AMP‐activated protein kinase (AMPK) and acetyl‐coenzyme A carboxylase (ACC), combined with the leptin signalling inhibitors suppressor of cytokine signalling 3 (SOCS3) and protein tyrosine phosphatase 1B (PTP1B) in human skeletal muscle of different age.
Protective Effects of Ischemic Preconditioning for Liver Resection Performed Under Inflow Occlusion in Humans

ObjectiveTo determine whether ischemic preconditioning protects the human liver against a subsequent period of ischemia in patients undergoing hemihepatectomy, and to identify possible underlying protective mechanisms of ischemic preconditioning, such as inhibition of hepatocellular apoptosis. Summary Background DataIschemic preconditioning is a short period of ischemia followed by a brief period of reperfusion before a sustained ischemic insult. Recent studies in rodents suggest that ischemic preconditioning is a simple and powerful protective modality against ischemic injury of the liver. The underlying mechanisms are thought to be related to downregulation of the apoptotic pathway. MethodsTwenty-four patients undergoing hemihepatectomy for various reasons alternatively received ischemic preconditioning (10 minutes of ischemia and 10 minutes of reperfusion) before transection of the liver performed under inflow occlusion for exactly 30 minutes. Liver wedge and Tru-cut biopsy samples were obtained at the opening of the abdomen and 30 minutes after the end of the hepatectomy. Serum levels of aspartate transferase, alanine transferase, bilirubin and prothrombin time were determined daily until discharge. Hepatocellular apoptosis was evaluated by in situ terminal deoxynucleotidyl transferase mediated d-UTP nick end-labeling (TUNEL) assay and electron microscopy. Caspase 3 and 8 activities were measured in tissue using specific fluorometric assays. ResultsSerum levels of aspartate transferase and alanine transferase were reduced by more than twofold in patients subjected to ischemic preconditioning versus controls. The analysis of a subgroup of patients with mild to moderate steatosis indicated possible increased protective effects of ischemic preconditioning. In situ TUNEL staining demonstrated a dramatic reduction in the number of apoptotic sinusoidal lining cells in the ischemic preconditioning group. Electron microscopy confirmed features of apoptosis present in control but not in ischemic preconditioning patients. There was no significant difference in caspase 3 and 8 activity when patients with ischemic preconditioning were compared with controls. ConclusionsIschemic preconditioning is a simple and effective modality protecting the liver against subsequent prolonged periods of ischemia. This strategy may be a more attractive technique than intermittent inflow occlusion, which is associated with increased blood loss during each period of reperfusion.
MRI in transverse myelitis

Transverse myelitis is an acute inflammatory disease of the spinal cord, characterized by rapid onset of bilateral neurological symptoms. Weakness, sensory disturbance, and autonomic dysfunction evolve over hours or days, most progressing to maximal clinical severity within 10 days of onset. At maximal clinical severity, half will have a paraparesis, and almost all patients have sensory disturbance and bladder dysfunction. Residual disability is divided equally between severe, moderate and minimal or none. The causes of transverse myelitis are diverse; etiologies implicated include demyelinating conditions, collagen vascular disease, and parainfectious causes, however, despite extensive diagnostic work‐up many cases are considered idiopathic. Due to heterogeneity in pathogenesis, and the similarity of its clinical presentation with those of various noninflammatory myelopathies, transverse myelitis has frequently been viewed as a diagnostic dilemma. However, as targeted therapies to optimize patient outcome develop, timely identification of the underlying etiology is becoming increasingly important. In this review, we describe the imaging and clinical features of idiopathic and disease‐associated transverse myelitis and its major differentials, with discussion of how MR imaging features assist in the identification of various sub‐types of transverse myelitis. We will also discuss the potential for advanced MR techniques to contribute to diagnosis and prognostication. J. Magn. Reson. Imaging 2014;40:1267–1279. © 2014 Wiley Periodicals, Inc.
Performance characteristics of a methodology to quantify adverse events over time in hospitalized patients.

OBJECTIVE To assess the performance characteristics of the Institute for Healthcare Improvement Global Trigger Tool (GTT) to determine its reliability for tracking local and national adverse event rates. DATA SOURCES Primary data from 2008 chart reviews. STUDY DESIGN A retrospective study in a stratified random sample of 10 North Carolina hospitals. Hospital-based (internal) and contract research organization-hired (external) reviewers used the GTT to identify adverse events in the same 10 randomly selected medical records per hospital in each quarter from January 2002 through December 2007. DATA COLLECTION/EXTRACTION Interrater and intrarater reliability was assessed using κ statistics on 10 percent and 5 percent, respectively, of selected medical records. Additionally, experienced GTT users reviewed 10 percent of records to calculate internal and external teams' sensitivity and specificity. PRINCIPAL FINDINGS Eighty-eight to 98 percent of the targeted 2,400 medical records were reviewed. The reliability of the GTT to detect the presence, number, and severity of adverse events varied from κ=0.40 to 0.60. When compared with a team of experienced reviewers, the internal teams' sensitivity (49 percent) and specificity (94 percent) exceeded the external teams' (34 and 93 percent), as did their performance on all other metrics. CONCLUSIONS The high specificity, moderate sensitivity, and favorable interrater and intrarater reliability of the GTT make it appropriate for tracking local and national adverse event rates. The strong performance of hospital-based reviewers supports their use in future studies.
Comparison of the neuromuscular blocking effect of cisatracurium and atracurium on the larynx and the adductor pollicis

Background: Cisatracurium unlike atracurium is devoid of histamine‐induced cardiovascular effects and this alone would be the greatest advantage in replacing atracurium for the facilitation of tracheal intubation. On the other hand, 2 ED95 doses of cisatracurium (100 µg/kg) do not yield satisfactory intubating conditions such as those seen with equipotent doses of atracurium and therefore the recommended intubating dose of cisatracurium is 3 ED95. To understand this discrepancy better, we evaluated the potency and onset of atracurium and cisatracurium directly at the larynx adductors in humans.
Different Presentations of Renal Cell Cancer on Ultrasound and Computerized Tomography

Renal cell carcinoma (RCC) is the most common malignant tumor of the kidney. The major goal of imaging techniques is to correctly differentiate between benign and malignant renal lesions. We present the cases of six patients with renal masses that were interpreted completely differently based on ultrasound (US) and computerized tomography (CT) findings. From January 1st, 2008 to March 1st, 2014, 307 patients from our center underwent nephrectomy for RCC. In all patients US and CT were performed before the operation. In six patients, the US indicated a focal, solid renal lesion that was interpreted by CT as a cystic lesion (Bosniak II-III). Because discrepancies were evident, renal biopsies were performed. The biopsies revealed RCC in the six patients, all of whom underwent subsequent nephrectomy. All of the patients were confirmed to have macroscopically solid RCC without any cystic components. In most cases, CT is the most accurate diagnostic technique for the clinical diagnostic classification of renal masses. In cases where US characterizes a renal lesion as solid, despite CT findings of a cystic lesion, kidney biopsies are recommended. The 6 cases reported here support our belief that, in diagnostic processes of RCC, these techniques should be complementary used.
Dental Plaque and Calculus: Risk Indicators for Their Formation

The aim of this study was to determine the levels of plaque and subgingival calculus accumulation and to evaluate their correlations with periodontal disease, as well as to evaluate the correlations with race, age, and gender in an attempt to identify risk indicators for plaque and calculus formation. A total of 508 adults 25-73 years of age was examined, and plaque assessment, gingival bleeding assessment, probing pocket depth, and attachment levels were determined. The mean percent visible plaque was 73.5% (range, 8.3-100%), mean percent of bleeding surfaces 38.5% (range, 0-100%), and the mean percent teeth with subgingival calculus 39.6% (range, 0-100%). The mean probing pocket depth in the group was 2.5 ± 0.6 mm (SD), and mean clinical attachment loss was 2.1 ± 1.1 mm. The majority (63%) were classified as having "Moderate" periodontal disease, 7% were "Healthy", and the remaining 30% had "Established" periodontal disease. Plaque and calculus showed statistically significant relationships to the three disease categories (p < 0.001). Multiple step-wise regression analyses on the correlations between plaque and periodontal disease, race, age, and gender resulted in an overall correlation coefficient of r = 0.25 (p < 0.001). Disease status ("Established") contributed most (p = 0.003), followed by race (Blacks; p = 0.015), gender (Males; p = 0.022), and age (55-73 yr; p = 0.022), to the correlation with plaque. For subgingival calculus, the overall correlation coefficient was r = 0.44 (p < 0.001). However, only two of the variables-namely, disease status (p < 0.001) followed by race (p = 0.017)-showed statistically significant correlations. In this population, age, being male, and being Black were risk indicators for supragingival plaque, while race alone was a risk indicator for subgingival calculus. Hence, it is reasonable to test intervention measures which effectively control plaque and subgingival calculus in these target groups to determine their importance in the development of periodontitis.
The effects of recent aspirin ingestion on platelet function in cardiac surgical patients.

OBJECTIVE To examine the effects of the preoperative aspirin-free interval on platelet function in cardiac surgical patients. DESIGN Prospective clinical investigation. SETTING University-affiliated teaching hospital. PARTICIPANTS Patients undergoing elective coronary artery bypass graft surgery (n = 100). INTERVENTIONS The patients were divided into 3 groups based on the number of days since they last ingested aspirin: < or =2 days, 3 to 7 days, and >7 days. Preoperative platelet function was assessed in all patients using platelet aggregation responses to arachidonic acid, 5 microg/mL, and Platelet Function Analyser (PFA100) collagen/epinephrine closure times. MEASUREMENTS AND MAIN RESULTS Patients who ceased aspirin < or =2 days preoperatively had weaker platelet aggregation responses (18.5% +/- 7% maximum aggregation, mean +/- SD, n = 36) than patients who ceased aspirin 3 to 7 days preoperatively (68.8% +/- 29%, n = 48, p < 0.001) or >7 days preoperatively (68.3% +/- 28%, n = 16, p < 0.001). Similarly, patients who ceased aspirin < or =2 days preoperatively had longer PFA100 closure times (168 +/- 52 sec) than patients who ceased aspirin 3 to 7 days preoperatively (122 +/- 43 sec, p < 0.001) or >7 days preoperatively (128 +/- 42 sec, p < 0.01). The percentage of abnormal responses was also greatest in the aspirin < or =2 days group. CONCLUSION Cardiac surgical patients who ingest aspirin < or =2 days preoperatively have greater impairment of platelet function than patients who have a longer preoperative aspirin-free interval.